残胃患者泌酸功能的检测分析  

Clinical Research of Acid Secreting Function in Patients with Gastric Stump

作　　者：严艳[1] 应力[1] 张丽梅[1] 姜春萌[1] 

机构地区：[1]大连医科大学第二临床学院消化内科,辽宁大连116027

出　　处：《中国误诊学杂志》2008年第5期1009-1011,共3页Chinese Journal of Misdiagnostics

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感染率无明显差异。62.7%的患者胃酸分泌减少,但却接受抑酸药物治疗。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。约1/3残胃患者保持正常胃酸分泌功能,临床上有大量患者接受了不必要的抑酸治疗。Objective：To investigate the acid secreting functional status of gastric stump and the clinical significance. Methods：pH value of gastric stump in 24 hours were monitored. Gastric mucosa were observed by endoscopy and biopsy. Helicobacter pylori were examined. Results：35 patients with partial gastrectomy showed phi3 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 significant difference between the two groups. About 62.7% patients which had no or little capability to produce acid receive acid suppressing therapy. Conclusions ： 24 h pH monitoring is an efficient method to detect mucous acid secreting function in patients with gastric stump. The degree of gastritis correlates with acid secretion of mucosa. Many patients which have lost normal acid secreting function receive unnecessary acid suppressing treatment.

关 键 词：胃切除术 螺杆菌 幽门 胃粘膜/病理学 螺杆菌感染/病理学 胆汁返流/病理学 人类 

分 类 号：R656.61[医药卫生—外科学]