BillrothⅠ和BillrothⅡ及Roux-Y术后液体胃排空和生活质量的改变  

Changes in liquid gastric emptying and quality of life after Billroth Ⅰ,Billroth Ⅱ and Roux-Y gastrectomy

作　　者：雷勇[1] 刘枫林[1] 

机构地区：[1]复旦大学中山医院普通外科,上海200032

出　　处：《中华胃肠外科杂志》2001年第4期258-261,共4页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的探讨BillrothⅠ、BillrothⅡ和Roux-Y术后液体胃排空变化以及对生活质量的影响。方法应用锝99m-植酸钠(99mTc-PHY)液体核素餐和γ闪烁成像仪SPECT,测定35只SD大鼠液体胃排空以及体重和血清白蛋白后,随机分成5组:假手术组(SG);剖腹探查组(LG);远端胃切除、胃十二指肠吻合组(BillrothⅠgroup,BⅠG);远端胃切除、胃空肠吻合组(BillrothⅡgroup,BⅡG),远端胃切除、胃空肠Roux-Y吻合组(R-Ygroup,R-YG)。术后第4、8和16周重复胃液体排空、体重和血清白蛋白测定。结果SG16周内液体胃排空无显著性改变(P>0.05);LG第4周液体胃排空明显延迟(P<0.01),第8周恢复到术前水平(P>0.05);BⅠG、BⅡG和R-YG术后第16周液体胃排空均未恢复到术前标准(P<0.01);体重恢复BⅠG和R-YG较BⅡG好(P<0.01)。结论(1)剖腹探查能暂时性抑制液体胃排空;(2)BⅠ、BⅡ和R-Y术后存在明显的液体胃排空延迟现象;(3)术后体重恢复以BⅠ最好,R-Y次之,BⅡ较差。Objective To explore the changes in liquid gastric emptying and quality of life after Billroth Ⅰ , Billroth Ⅱ and Roux Y procedures.Methods With 99mTc PHY labeled liquid meal and gamma scintillating imaging apparatus SPECT, 35 Sprague Dawley (SD) rats that had been taken measurements of the liquid gastric emptying function test, body weight (Wt) and serum albumin (SA) were randomly divided into five groups averagely: the sham group(SG), the laparotomy group(LG), Billroth Ⅰ group(BⅠG), Billroth Ⅱ group(BⅡ G), gastrectomy Roux Y group(R YG). Liquid gastric emptying,Wt and SA were periodically measured for rats after surgery. Results (1) In SG, rats showed no significant changes in liquid gastric emptying within 16 weeks.(2) In LG, animals restored their functions of liquid gastric emptying of the preoperative values until the 8th week after opration.(3)In BⅠ G, BⅡ G and R YG, liquid gastric emptying showed a significant delay as compared with the values before surgery (P< 0.01) within 16 weeks.(4)The Wt in BⅠ G was the best, better in R YG.Conclusions (1) Laparotomy can temporarily inhibit the liquid gastric emptying. (2) Liquid gastric emptying after BⅠ , BⅡ and R Y delays significantly even when the effect of laparotomy is ruled out. (3) The recover in wtof BⅠ is the best , that of R Y is better than that of BⅡ .

关 键 词：Billroth术 ROUX-Y术 液体胃排空 生活质量 胃切除术 消化道重建术 

分 类 号：R656.6[医药卫生—外科学]