摘要
目的调查胃小弯和胃底部浆肌层切开术（ＬＧＣＦＳ）治疗十二指肠溃疡及其并发症的远期疗效。方法采用信访、电话访问、门诊复查等方式对１９８３～１９８９年间施行ＬＧＣＦＳ的５５例十二指肠溃疡患者进行随访，疗效按Ｖｉｓｉｃｋ标准分级。结果获得随访４７例，失访８例。Ｖｉｓｉｃｋ分级：（１）３２例无并发症的十二指肠溃疡，Ｉ级２５例（７８．１％），Ⅱ级２例（６．３％），Ⅲ级３例（９４％），Ⅳ级２例（６．３％）；（２）１５例有并发症的十二指肠溃疡，Ⅰ级５例（３３．３％），Ⅱ级２例（１３３％），Ⅲ级２例（１３．３％），Ⅳ级６例（４０．０％）；（３）全部４７例患者，Ⅰ级３０例（６３．８％），Ⅱ级４例（８．５％）， Ⅲ级５例（１０．６％）， Ⅳ级８例（１．０％）。结论 ＬＧＣＦＳ操作简单，并发症少。对于无并发症的十二指肠溃疡，其远期疗效优良。但对于有并发症者，疗效较差；尤其是对于并发幽门梗阻者，ＬＣＧＦＳ加幽门扩张术后梗阻复发率极高，应避免选用。
Objective To research the long-term curative effects of lesser gastric curve and fundus seromyotomy (LGCFS) for the treatment of duodenal ulcer and its complications. Methods Fifty-five patients with duodenal ulcer having undergone LGCFS from 1983 to 1989 were followed up by means of letters,telephone and outpatient reexamine.The curative effects were classified by the Visick scale. Results Fourty-seven patients entered this study. The Visick classification results were: (1) 25 (78. 1% ), two(6.3% ), three(9.4% ) and two(6.3%) cases being classified as Visick Ⅰ, Ⅱ, Ⅲ and Ⅳ respectively among 32 patients without any complication. (2) five (33.3%), two(13. 3%), two(13.3%) and six (40%) cases being classified as Visick Ⅰ,Ⅱ, Ⅲ and Ⅳ respectively among 15 patients with complications. (3) 30 (63. 8% ), four (8.5% ), five (10.6% ) and eight (17.0% ) cases were classified as Visick Ⅰ, Ⅱ, Ⅲ and Ⅳ respectively among all patients (47 cases). Conclusion LGCrs is simple and has few complications. The long term curative effect is good for duodenal ulcer without any complication. But it is bad for duodenal ulcer with complications, especially for duodenal ulcer with pyloric obstruction because of the high recurrent rate of pyloristenosis after LGCFS plus pylorodiosis.
