胃手术后胆汁反流和胃内菌丛变化对残胃粘膜病变的影响  

Effects of bile reflux and intragastric microflora changes on lesions of remnant gastric mucosa

作　　者：张超[1] 吴国庆[1] 蔡志民[1] 黄文[1] 

机构地区：[1]第三军医大学附属西南医院普通外科

出　　处：《第三军医大学学报》1999年第5期341-343,共3页Journal of Third Military Medical University

摘　　要：目的：了解不同的胃手术术后胆汁反流和胃内菌丛变化对残胃粘膜的影响。方法：观察了４９例溃疡病患者手术前后空腹胃液胆酸浓度及胃内菌量变化，并对术后１年的患者进行胃粘膜组织学检查。结果：发现Ｂ－Ⅱ组和Ｂ－Ⅰ组及ＳＶ＋Ｖ组术后胃液胆酸浓度及菌量均显著高于ＨＳＶ组（Ｐ＜０．０５～０．０１），胃粘膜组织学异常改变的程度较ＨＳＶ组严重（Ｐ＜０．０５）。结论：由于胃手术方式的不同对术后胆汁反流可产生重要影响；残胃粘膜组织学异常改变与胃液胆酸浓度升高和胃内细菌增多有关；ＨＳＶ能较有效地减少肠胃反流，使胃内环境保持相对稳定。Objective: To investigate the effects of bile reflux and intragastric microflora changes on lesions of remnant gastric mucosa. Methods: The concentration of bile acid and total bacterial counts (TBC) in gastric juice were measured in 49 patients with peptic ulcer before and after gastric operation. One year after the operation, samples of gastric mucosa taken from all the patients were used for histological examination. Results: After the operation, the concentration of gastric bile acid was significantly higher in groups B, or B and SV+A than in group HSV (P<0.050.01). TBC in the former two groups was increased much more than that in the latter group (P<0.050.01). The abnormal histological changes in the remnant gastric mucosa were more common in the first two groups than in the last group. Conclusion: The type of gastric operation can affect bile reflux. The abnormal histological changes in the remnant gastric mucosa are closely related to the elevation of bile acid concentration and increase of TBC in gastric juice. HSV can effectively prevent bile reflux and keep the gastric physiological functions stable.

关 键 词：胃手术 胆汁反流 消化性溃疡 手术后 菌丛 

分 类 号：R656.610.6[医药卫生—外科学] R573[医药卫生—临床医学]