摘要
通过测定３８例十二指肠溃疡患者行高选迷切加胃窦粘膜切除术（ＨＳＶ＋ＭＡ）前后胃窦粘膜幽门螺杆菌（ＨＰ）、胃酸、血清胃泌素值的变化，以了解ＨＳＶ＋ＭＡ对其影响及ＨＰ与胃酸、胃泌素的关系。结果显示：①ＨＳＶ＋ＭＡ后３～６月及３～７年胃窦粘膜ＨＰ感染率明显低于术前；②ＨＳＶ＋ＭＡ后３～６月及３～７年血清胃泌素水平空腹及蛋白餐后１５，３０，４５，６０分钟均低于术前，术后３～７年较３～６月有所升高，但不显著；③胃粘膜ＨＰ阳性组胃酸分泌明显高于阴性组；血清胃泌素水平空腹及蛋白餐后１５分钟较阴性组升高，但不显著；餐后３０，４５，６０分钟明显高于阴性组，相差显著。提示幽门螺杆菌与十二指肠溃疡的发生和复发有密切关系。结果表明，高选迷切加胃窦粘膜切除术能明显地降低幽门螺杆菌感染率、降低胃酸、术后不发生高胃泌素血症。
In order to investigate the effect of high selective vagotomy and mucosal antrectomy (HSV+MA) on helicobacter pylori (HP), gastric acid and serum gastrin and their mutual relation in patients with duodenal ucler after operation, 38 patients with chronic duodenal ulcer treated with HSV+MA were analysed. The results showed that: ① infectious rate of HP in antral mucosa (AM) in patients in 3～7 years and 3～6 months after operation was significantly decreased than that in patients before operation; ②the concentration of gastrin in serum on an empty stomach and at 15,30,45,60 minutes after eating eggs in postoperative patrents were significantly lower than that in patients before operation; ③the secretion of gastric acid was significantly increased in patients with HP in AM than that in patients without HP in AM; the concentration of gastrin in serum on an empty stomach was increased in patients with HP in AM 15 minutes after eating eggs than that in patients withyout HP in AM; but without significant difference; but 30,45,60 minutes after eating eggs, the increase was very significant in patients with HP in AM than that in patients without HP in AM. The results suggest that the occurrence and recurrence of duodenal ulcer have a rather close relation with HP; and that HSV+MA could decrease clearly the infectious rate of HP and the secretion of gastric acid, and do not cause postoperative hypergastrinemia. So HSV+MA could cure duodenal ulcer and decrease its recurrence.
出处
《中国普通外科杂志》
CAS
CSCD
1998年第2期90-93,共4页
China Journal of General Surgery
