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以往,日本对溃疡病的外科治疗,几乎都是以胃大部切除术作为唯一的手术方法。但随着对发病机制的深入理解,认识到胃溃疡与十二指肠溃疡的发病机制不同,同一疾病在不同患者中的表现也不完全一致,因而用单一的手术方法不适于各种病因、病情的治疗需要。所以近10余年来,特别自开展迷走神经切断术以来,一些大医疗单位开始根据胃酸、溃疡部并相应考虑有无胃扩张或其他病变、周身情况、年龄以及术后功能恢复、并发症、安全性等,选出较为合理的手术方法;少数单位也将血浆胃泌素作为选择手术方法的参考之一。关于胃酸,应注意增高程度、头相或胃相那方占优势和不同手术方法的降酸效果。但除
In the past, surgical treatment of ulcer disease in Japan was almost exclusively based on gastrectomy as the only surgical method. However, with the in-depth understanding of the pathogenesis, it is recognized that the pathogenesis of gastric ulcer and duodenal ulcer is different, and that the same disease is not exactly the same in different patients, so a single surgical method is not suitable for various causes. Treatment needs of the condition. Therefore, in the past more than 10 years, since the vagotomy has been performed in particular, some major medical institutions have begun to consider gastric acid and ulcers and considered whether or not there is stomach dilatation or other pathological changes, general condition, age, postoperative functional recovery, complications, and safety. And so on, select a more reasonable surgical method; a few units will also use plasma gastrin as one of the reference for the choice of surgical methods. Regarding gastric acid, attention should be paid to the degree of increase, the predominance of the cephalic or gastric phase, and the acid-reducing effect of different surgical methods. But except