胃大部切除术后的胆汁返流及残胃粘膜病变  

INFLUENCE OF SUBTOTAL GASTRECTOMY ON BILE REFLUX AND HISTOLOGIC CHANGES OF REMNANT GASTRIC MUCOSA

作　　者：张超[1] 黄文[1] 

机构地区：[1]第三军医大学西南医院普通外科

出　　处：《内镜》1995年第3期131-134,共4页

摘　　要：本文观察了４４例消化性溃疡患者手术前后空腹胃液胆酸浓度变化，对术后１年的３３例行胃镜及胃粘膜组织学检查。发现Ｂ－Ⅱ式组和Ｂ－Ⅰ式组术后胃液胆酸浓度显著高于ＰＡＦＰＧ组；胃镜所见肠胃返流及胃炎表现亦较ＰＡＦＰＧ组严重（Ｐ＜０．０１）；胃粘膜组织学异常改变的程度重于ＰＡＦＰＧ组（Ｐ＜０．０５）。结果表明：不同胃切除术式所引起的胆汁返流及残胃粘膜病变程度各异，ＰＡＦＰＧ能较有效地减少肠胃返流，使胃内环境保持相对稳定。The concentrations of bile acids in the fasting gastric juice were measured among 44 patients with peptic ulcer before and after subtotal gastrectomy (Billroth Ⅱin 14 cases, Billroth Ⅰin 10 cases,and PAFPG in 20 cases).Thirty three patients were studied by endoscopy and gastric mucosa biopsy 1 year postoperatively. The results showed that the bile acid concentrations in both B-Ⅱ and B-Ⅰ groups were significantly higher than in PAFPG group following operation.While endoscoping, the duodenogastric bile reflux was greater and the remnant gastritis was more severe in B-Ⅱ or B-Ⅰ group than PAFPG group(P<0. 01). The abnormal histologic changes in gastric remnant mucosa were more common after B-Ⅱ or B-Ⅰ reconstruction,compared with PAFPG.These findings suggest that there are many differences between the bile reflux and the histologic changes in gastric mucosa following different partial gastric resection, while PAFPG can prevent bile reflux effectively and keep the gastric environment in a relative status.

关 键 词：胃切除术 胃粘膜 病变 胆汁返流 

分 类 号：R656.610.5[医药卫生—外科学] R657.4[医药卫生—临床医学]