摘要
目的 探讨胃大部切除术后复发性溃疡的主要原因和治疗。方法 回顾性分析1978～ 1998年间收治的 32例术后复发性溃疡的临床资料。结果 胃大部切除术后复发率3 %。高泌酸量者 81% ;并幽门螺旋菌 (HP)感染 6 5 %。治愈 31例 ,死亡 1例。内科治愈率6 9 2 % ,手术治愈率 92 8% ,随访 1～ 12年 ,治愈者均无溃疡再复发。结论 术后复发性溃疡的主要原因是残胃泌酸量高和吻合口HP感染。对未穿孔的复发性溃疡者应首先采用内科治疗 ,外科手术仅适于合并有穿孔。
Objective To investigate the main causes and treatment of recurrent ulcer(RU) after sublotal gastrectomy. Methods The clinical data of 32 cases of RU after subtotal gastrectomy admitted from 1978 to 1998 were retrospectively analysed. Results The recurrent rate of subtotal gastrectomy was 3% in our hospital. The RU occurrent rate was 81% in patients with gastroxynsis, helochbacter pylori(HP) infection was 65% in RU patients. 31 patients were cured while 1 patient died. The curative rate of medical cure was 69.2%, the curative rate of surgery 92.8%. All patients cured by medical therapy of surgery were followed up for 1～12 years, and no recurrent ulcer reappeared. Conclusions The main cause of RU after subtotal gastrectomy is gastroxynsis in remnants stomach and HP infection on anastomotic stoma. For the patients with RU without perforation, medical treatment should be adopted first. Surgery operation is suitable for the RU patients with perforation, gastrojejunocolic fistula or for medical therapy cases without effect.
出处
《中国普通外科杂志》
CAS
CSCD
2000年第4期335-337,共3页
China Journal of General Surgery
