论文部分内容阅读
胃大部切除术后残胃的萎缩性胃炎(AG)发病率各家报告不一。鉴于病例中未能将手术前AG剔除,从而造成一定的混淆。本文报告了146例消化性溃疡采用毕氏Ⅰ或Ⅱ式胃大部切除后的胃粘膜变化,各例于手术时和术后2年都作了胃粘膜活检。胃粘膜的改变分为五级:正常、轻度病变及萎缩性胃炎Ⅰ～Ⅲ级。在146例中,手术时发现有AG者8例,余138例胃粘膜正常(111例)或仅呈轻度病变(27例)。这138例于术后2年出现了AG者74例(54％),其中十二指肠溃疡出现AG者46％,胃溃疡出现AG者73％,二者在统计学上有非常显著差异,特别是胃窦与幽门管溃疡发生AG者高达81％。8例手术时有不同程度AG的病例,其中7例术后2年AG加重,另1例仅有轻度病变。手术时胃粘膜呈轻度病变的27
The incidence of atrophic gastritis (AG) in the residual stomach after subtotal gastrectomy has been reported differently. In view of the failure to exclude the pre-operative AI in the case, it caused some confusion. This article reports the gastric mucosal changes in 146 patients with peptic ulcers who underwent major gastrectomy with Type I or II gastrectomy. The gastric mucosal biopsies were performed at the time of surgery and at 2 years after surgery. Changes in gastric mucosa were divided into five levels: normal, mild lesions, and atrophic gastritis I-III. Among the 146 cases, 8 cases were found to have AG at the time of surgery, and the remaining 138 cases had normal gastric mucosa (111 cases) or only mild cases (27 cases). Among these 138 cases, 74 patients (54%) had AG at 2 years after operation. Among them, 46% were found in duodenal ulcers and 73% in patients with gastric ulcers. There was a statistically significant difference between the two groups. In particular, up to 81% of patients with gastric antrum and pyloric ulcers developed AG. Eight cases had AG with different degrees of operation, of which 7 cases had AG worsening at 2 years after operation and the other had only mild disease. Gastric mucosa showed mild lesions during surgery