中国实用外科杂志

中国实用外科杂志 ›› 2009, Vol. 29 ›› Issue (10): 842-843.

• 论著 • 上一篇    下一篇

胃小弯和胃底部浆肌层切开术治疗十二指肠溃疡55例疗效分析

蒋小春1，许瑞云2   

  1. 1中国人民解放军第113医院普外科，浙江宁波315040；2中山大学附属第三医院普外科，广东广州510630
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-10-01 发布日期:2009-10-01

  • Received:1900-01-01 Revised:1900-01-01 Online:2009-10-01 Published:2009-10-01

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摘要：

目的 调查胃小弯和胃底部浆肌层切开术（LGCFS）治疗十二指肠溃疡及其并发症的远期疗效。方法 中山大学附属第三医院采用信访、电话访问、门诊复查等方式对1983-1991 年间施行LGCFS 的55 例十二指肠溃疡病人进行随访，疗效按Visick 标准分级。结果 获得随访47 例，失访8 例。Visick 分级：（1）32 例无并发症的十二指肠溃疡，I 级25 例（78.1%），II 级2 例（6.3%），III 级3 例（9.4%），IV 级2 例（6.3%）；（2）15 例有并发症的十二指肠溃疡，I 级5 例（33.3%），II 级2 例（13.3%），III 级2 例（13.3%），IV 级6 例（40.0%）；（3）全部47 例病人，I 级30 例（63.8%），II 级4 例（8.5%），III 级5 例（10.6%），IV 级8 例（17.0%）。结论 LGCFS 操作简单，并发症少，对于无并发症的十二指肠溃疡，其远期疗效优良。但对于有并发症者，疗效较差。尤其是对于并发幽门梗阻者，LGCFS 加幽门扩张术后梗阻复发率极高，应避免选用。

关键词: 近端胃迷走神经切断术, 十二指肠溃疡

Abstract:

Long-term follow-up of lesser gastric curve and fundus seromyotomy for the treatment of duodenal ulcer and its complication: an analysis of 55 cases JIANG Xiao-chun*，XU Rui-yun. *Department of Surgery, the 113th Hospital of PLA, Ningbo 315040,China Corresponding author: JIANG Xiao-chun，E-mail: jiangxc1963@yahoo.cn Abstract Objective To research the long-term curative effects of lesser gastric curve and fundus seromyotomy (LGCFS) for the treatment of duodenal ulcer and its complications. Methods Fifty-five cases of duodenal ulcer performed LGCFS from 1983 to 1991 at the Third Affiliated Hospital of SUN Yat-sen University were followed up by means of letters, telephone and outpatient reexamine. The curative effects were classified by the Visick scale. Results Forty-seven cases were followed up.The Visick classification results were: (1) Twenty-five (78.1%), 2(6.3%), 3(9.4%) and 2(6.3%) cases being classified as Visick I,II,III,IV respectively among 32 cases without any complication.(2) Five (33.3%), 2(13.3%), 2(13.3%) and 6(40.0%) cases being classified as Visick I,II,III,IV respectively among 15 cases with complications. (3) Thirty (63.8%), 4 (8.5%), 5 (10.6% ) and 8 (17.0% ) cases were classified as Visick I,II,III,IV respectively among 47 cases. Conclusion LGCFS is simple and has few complications.The long term curative effect is good for duodenal ulcer without any complication.But it is bad for duodenal ulcer with complications,especially for duodenal ulcer with pyloric obstruction because of the high recurrent rate of pyloristenosis after LGCFS plus pylorodiosis.

Key words: proximal stomach vagotomy, duodenal ulcer