105例老年胃大部切除术后残胃病变的回顾分析  

Retrospective analysis of remnant stomach in the elderly after subtotal gastrectomy:a report of 105 cases

作　　者：施剑兵 仲恒高[2] 黄锦[2] 范志宁[2] 

机构地区：[1]江苏省张家港市乐余镇人民医院,江苏张家港215613 [2]南京医科大学第二附属医院消化医学中心,江苏南京210012

出　　处：《中国内镜杂志》2011年第8期845-847,851,共4页China Journal of Endoscopy

摘　　要：目的回顾分析老年残胃病变的临床特点及胃镜表现。方法对105例老年胃大部切除术后残胃病变患者的临床资料进行回顾性分析。105例患者中,34例(32.38%)采用毕Ⅰ(BⅠ)式手术,71例(67.62%)采用毕Ⅱ(BⅡ)式手术,所有患者均行胃镜及组织病理检查。结果所有患者中残胃癌15例(14.29%),吻合口及残胃溃疡14例(11.43%),胆汁反流42例(40.0%),吻合口及残胃炎34例(32.38%)。并发息肉13例(12.38%),幽门螺杆菌阳性33例(31.43%)。统计分析显示,BⅡ式术后残胃癌、吻合口及残胃炎、胆汁反流的发生率高于(BⅠ)式(P<0.05),而BⅡ幽门螺杆菌阳性率较BⅠ低(P<0.05)。结论 BⅡ式较BⅠ式术后更易发生并发症,老年残胃癌变、炎症和胆汁反流发生率均较高,应定期随防胃镜及病理检查。[Objective] To explore the endoscopic and pathological characteristics of remnant stomach in the elderly after subtotal gastrectomy.[Methods] The clinical data of 105 elderly patients with subtotal gastrectomy from January 2008 to December 2010 were reviewed and analyzed.In all 105 cases,34 patients（32.38%） were selected Billroth＇s operation Ⅰ and 71 patients（67.62%） were selected Billroth＇s operation Ⅱ,all patients underwent gastroscope and biopsy.[Results] Fifteen patients（14.29%） showed gastric stump cancer,14 patients（11.43%） showed stoma or residual ulcer,42 patients（40.0%） showed bile reflux,34 patients（32.38%） showed stoma or residual inflammation,while 13 patients（12.38%） showed residual polyp and 33 patients（31.43%） showed Helicobacter pylori infection.Compared with patients with Billroth＇s operation Ⅰ,not only rate of gastric stump cancer,but also rate of stoma or residual ulcer and inflammation and bile reflux were higher in patients with Billroth＇s operation Ⅱ（P 0.05）.However,the helicobacter pylori infection rate was lower than patients with Billroth＇s operation Ⅰ（P 0.05）.[Conclusion] Patients with Billroth＇s operation Ⅱ are more likely to develop complications in the elderly,the ratio of cancerization and inflammation and bile reflux were higher than patients with Billroth＇s operation,periodically endoscopy inspection and biopsy are necessary.

关 键 词：残胃病变 胃镜检查 病理检查 老年人 

分 类 号：R573[医药卫生—消化系统]