胃肌层内迷走神经切断术治疗十二指肠溃疡穿孔疗效评价  

The value of gastric muscle layer vagotomy in the treatment of duodenal ulcer perforation

作　　者：王瑞 胡孝海 魏学峰 张华英 

机构地区：[1]深圳市龙岗区坪山人民医院,518118 [2]深圳市人民医院龙华分院

出　　处：《中国临床实用医学》2009年第2期108-109,共2页China Clinical Practical Medicine

摘　　要：目的评价胃肌层内迷走神经切断术式治疗十二指肠溃疡穿孔患者的疗效。方法胃肌层内迷走神经切断术治疗十二指肠溃疡穿孔患者52例，并与同期十二指肠溃疡穿孔行单纯缝合修补术41例患者对比分析。结果A（治疗组）、B（对照组）二组病例术后5-肽胃泌素胃酸分泌试验：基础排酸量（BAO）、最大排酸量（MAO）、高峰排酸量（PAO），两组差异有统计学意义（P〈0．01），所有患者随访3个月至6年，治疗组无1例复发，对照组复发12例（29．3％），再次手术7例（17％）。治疗效果按Visiek分级：Ⅰ、Ⅱ级治疗组达94．2％对照组为48．8％。结论胃肌层内迷走神经切断术治疗十二指肠溃疡穿孔具有迷走神经切断彻底、操作简捷、并发症少，疗效优于单纯缝合修补术。Objective To evaluate the effect of gastric muscle layer vagotomy for the treatment of duodenal ulcer perforation. Methods Since 1998 February, have treated 52 cases patients of duodenal ulcer perforation by gastric muscle layer vagotomy and 41 cases treated with simplicity suture of the perforation duodenal ulcer. Results A （ therapy groups）, B （ comparison groups） With postoperative pentagastrin stimulation ： the base acid output（BAO） ,maximum acid output （MAO）and peak acid output （PAO）, There were significant difference between in two groups（ P 〈 0.01 ）. All patients were followed up from 3 months to six years. There was no ulcer recurrence in the therapy groups. Recurrence was found of 12 cases （ 29.3% ） in the comparison groups, again surgical operation 7 cases（ 17% ）. Using a Visick grading,94. 2% of patients were classified as Ⅰ and Ⅱ in the therapy groups and 48.8% in the comparison groups. Conclusion The gastric muscle layer vagotomy is an easy and rapid procedure with less complications ,The curative effect is better than simplicity suture of the duodenal ulcer perforation.

关 键 词：十二指肠溃疡穿孔 迷走神经切断术 单纯缝合修补术 

分 类 号：R656.62[医药卫生—外科学] R571[医药卫生—临床医学]