胃壁内折返神经纤维选择性切断术治疗十二指肠球部溃疡  

Highly selective vagotomy resecting the parietal return nerve fiber for the treatment of duodenal ulcer

作　　者：张立学[1] 罗德光[1] 赵向东[1] 冯立民 黄云飞[1] 

机构地区：[1]吉林省四平市中心医院外一科,136000

出　　处：《中华普通外科杂志》2000年第2期75-77,共3页Chinese Journal of General Surgery

摘　　要：目的　评价切断胃壁内折返神经纤维的高选择性胃迷走神经切断术的疗效。方法　采用切断胃壁内折返神经纤维的高选择性胃迷走神经切断术治疗十二指肠球部溃疡及并发狭窄和急性穿孔的患者 65例 ,61例获随访 ,随访期 5～ 16年。结果　本手术降低了最大胃酸分泌量 (maximumacidoutput,MAO) :术后 1～ 3个月与术前相比 ,差异有显著性(t=3 2 18,P <0 0 5 ) ;术后 3～ 6个月与术前相比 ,差异有显著性(t=2 895 ,P <0 0 5 )。溃疡复发率 1 6%。VisickⅠ级 85 %、Ⅱ级 12 %、Ⅲ、Ⅳ级 3 %。结论　此术式符合解剖和生理特点 ,是治疗十二指肠球部溃疡的有效术式。Objective To evaluate the effect of highly selective vagotomy (HSV) resecting the parietal return nerve fiber for the treatment of duodenal ulcer. Methods A total 65 patients with duodenal ulcer,complicated by structure or acute perforation were treated with this kind of HSV,and 61 petients were followed up from 5 to 16 years.Results The postoperative maximum acid output (MAO) significantly decreased,compared with preoperative status when measured in a period of 1～3 months postoperatively ( t =3.218, P <0.05),and in 3～6 months postoperatively ( t =2 895, P <0 05).The recurrent rate of ulcer in this group is 1 6%,and the postoperative Visick grade Ⅰ takes 85%, grade Ⅱ 12%, grade Ⅲ and Ⅳ 3%.Conclusion Our result shows that this modality of surgery is safe and satisfactory for the treatment of duodenal ulcer.

关 键 词：消化性溃疡 迷走神经切断 十二指肠 球部溃疡 

分 类 号：R656.62[医药卫生—外科学]