改良Goligher高选择性迷走神经切断术治疗消化性溃疡病:附217例报告

Modified Goligher high selective vagotomy in the treatment of duodenal ulcer: a report of 217 cases

目的 探讨改良Goligher高选择性迷走神经切断术 (MGHSV )治疗各种类型十二指肠溃疡的远期疗效。方法 对 1975～ 1992年施行MGHSV术的 2 17例十二指肠溃疡的临床资料进行回顾性分析。结果 所有患者均治愈出院。其中 2 0 9例获得随访 ,随访率达 96.3 % ;随访时间 10～ 2 0(平均 14 )年。术后疗效按Visick分级 ,无并发症十二指肠溃疡组中I～II级 15 4例 ( 86.1% ) ,III级12例 ( 6.7% ) ,IV级 13例 ( 7.3 % ) ;有并发症十二指肠溃疡组中I～II级 3 2例 ( 84.2 % ) ,III级 4例( 10 .5 % ) ,IV级 2例 ( 5 .3 % ) ,组间无统计学差异 (P >0 .0 5 )。两组均取得理想疗效。结论 MGHSV对十二指肠溃疡及其并发症的处理是较为理想的手术方法 ,远期疗效好 ,值得在临床推广。

Objective To investigate the long-term effect of modified Goligher high selective vagotomy (MGHSV) in the treatment of various types of duodenal ulcer. Methods The clinical data of 217 cases of duodenal ulcer undergoing MGHSV during 1975 and 1992 were reviewed retrospectively. Results All the patients were cured and discharged.209 cases (96.3 %) were followed up for 10-20 (averaged 14) years. Visick grading was applied to evaluate the postoperative effects. In non-complication duodenal ulcer group, 154 cases (86.1%) were classified as grade I-II, 12 cases (6.7%) as grade III and 13 cases (7.3%) as grade IV; in the duodenal ulcer with complications group, 32 cases (84.2%) were classified as grade I-II, 4 cases (10.5%) as grade III and 2 cases(5.3%)as grade IV, which showed no statistical difference between the two groups (P>0.05), and both groups got ideal clinical effect. Conclusions MGHSV is an ideal operation for various types of duodenal ulcer, which with a preferable long-term effect. It is worth to be widely applied in clinical practice.