保留交感神经的壁细胞迷走神经切断术治疗十二指肠溃疡

Parietal cell vagotomy with adrenergic preservation for duodenal ulcer

目的 探讨保留交感神经的壁细胞迷走神经切断术治疗十二指肠溃疡的疗效。方法 3 6例病人行保留交感神经的壁细胞迷走神经切断术 ,其中 2 7例为十二指肠溃疡并穿孔 ,5例为合并出血 ,2例为合并狭窄 ,2例为单纯十二指肠溃疡 ;评价病人术后死亡率、并发症的发生率及溃疡再发率。结果 全组均获随访 2 4个月 ,无手术死亡率 ,无术后再出血 ,1例溃疡再发 ,Visick指数Ⅰ级为 69.4% ,Ⅱ级为 19.4%。结论 保留交感神经的壁细胞迷走神经切断术为治疗十二指肠溃疡及其并发症的简单易行、有效的手术方式。

Objective To explore parietal cell vagotomy with adrenergic preservation(PCV-AP) in the treatment of duodenal ulcer.Methods 36 patients with duodenal ulcer were treated by PCV-AP.Among them,27 patients had acute perforation,5 patients hemorrhage and 2 patients stenosis.The patients were studied retrospectively with regard to postoperative mortality and morbidity,recurrent ulceration.Results 36 patients were followed for 24 months.One patient(2.8%)developed recurrent ulcer.There was no operative mortality.There was no recurrent hemorrhage and there were few long-term complications.Visick classification indicated that gradeⅠ,Ⅱ,Ⅲ and Ⅳ were 69.4%,19.4%,8.3% and 2.8% respectively,gradeⅠ and Ⅱ were 88.9%.Conclusions PCV-AP may be used as an operation for duodenal ulcer.