胃pH监测对残胃黏膜泌酸功能的应用价值  

Clinical research of acid secreting function in patients with gastric stump

作　　者：应力[1] 朱庆华[1] 姜铀[1] 姜春萌[1] 

机构地区：[1]大连医科大学附属第二医院消化内科,辽宁省大连116023

出　　处：《中国基层医药》2007年第11期1785-1786,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的研究胃远端部分切除术后患者泌酸功能及其与黏膜病理改变、胆汁反流和幽门螺杆菌(Hp)感染的相关性。方法采用24 h pH监测仪测定51例残胃患者空腹胃内pH值,根据24 h胃内平均pH值分为低泌酸组(pH≥3)和正常泌酸组(pH<3)。胃镜观察残胃黏膜以及Hp检测。结果低泌酸组患者35例,其中29例黏膜呈重度萎缩;正常泌酸组16例,其中4例呈重度黏膜炎症(P=0.006)。胆汁反流率在低泌酸组和正常泌酸组分别为37.4%和18.7%(P=0.014)。两组间Hp感染率差异无统计学意义。62.7%的患者胃酸分泌减少,但却接受了抑酸药物药物治疗。结论24 h动态胃pH监测可有效评价残胃患者胃黏膜泌酸功能。胆汁反流和残胃炎程度与黏膜泌酸功能有明显相关性。Ohjective To investigate acid-secreting functional status of gastric stump and the clinical significance. Methods pH value of gastric stump in 24 hours were monitored. Gastric mueosa was observed by endoscopy and biopsy. Helicobaeter pylori were examined. Results 35 patients with partial gastrectomy showed pHil-3 in 24 hours,including 29 with atrophic gastritis. 16 showed pH〈 3, including 4 with severe gastritis. The ratio of bile reflux in patients with 24-hour-pH mean value ~3 and 〈 3 were 37.4 % and 18.7 % ,respectively. There was no sig- nificant difference 1）c;ween the two groups. About 62.7 % patients which had no or little capability to produce acid received acid suppressing therapy. Conclusions 24h pH monitoring was an efficient method to detect mucous acid secreting function in patients with gastric stump. The presence of bile reflux and the degree of gastritis correlated with acid secretion of mucosa.

关 键 词：氢离子浓度 胃酸 胃残端 幽门螺杆菌 

分 类 号：R656.62[医药卫生—外科学] R573[医药卫生—临床医学]