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目的十二指肠球溃疡合并反流性食管炎(DU-GERD)的病因探讨。方法经电子胃镜及携带式24 h食管内pH监测确诊为十二指肠球溃疡合并反流性食管炎患者,在7 d内用磁性示踪法测定胃排空时间。结果以82例健康人胃排空时间T_(1/2) ±s 51.8±21.6min(30-74 min)为对照组。十二指肠球溃疡合并反流性食管炎58例,其中复发性球溃疡流出道受阻40例,胃排空加速0.0%(0/40),胃排空正常7.5%(3/40),胃排空延缓92.5%(37/40),T_(1/2) ±s 89.3±41.2min,与正常人对照组相比较x~2及t检验P<0.01,有非常显著性差异。初发性球溃疡流出道通畅18例,胃排空加速0.0%(0/18),胃排空正常44.4%(8/18),胃排空延缓55.6%(10/18),T_(1/2) ±s49.3±16.3 min,与流出道受阻组相比较x~2及t检验P<0.01,有显著性差异。结论 DU-GERD发生于慢性十二指肠球溃疡的基础上,而致胃运动功能障碍,胃排空延缓导致食管下端括约肌功能下降,胃反流长期浸渍食管粘膜受损发生反流性食管炎。
Objective To investigate the etiology of duodenal ulcer complicated with reflux esophagitis (DU-GERD). Methods Patients with duodenal ulcer complicated with reflux esophagitis were diagnosed by electronic gastroscope and portable 24 h esophageal pH monitoring. The gastric emptying time was measured by magnetic tracing within 7 days. Results The gastric emptying time of 82 healthy persons was T 1/2 (1/2) ± 51.8 ± 21.6min (30-74 min) as the control group. There were 58 cases of duodenal ulcer with reflux esophagitis, of which 40 cases had outflow tract obstruction of recurrent ball ulcer, 0.0% (0/40) accelerated gastric emptying and 7.5% (3/40) normal gastric emptying. The delayed gastric emptying was 92.5% (37/40) and T 1/2 (1/2 s ± 89.3 ± 41.2 min), which was significantly different from that of the normal control group (P <0.01). Twenty-eight patients had primary ascites obstruction, 0.0% (0/18) gastric emptying, 44.4% (8/18) normal gastric emptying, 55.6% (10/18) delayed gastric emptying, / 2) ± s49.3 ± 16.3 min, compared with the outflow tract obstruction group x ~ 2 and t test P <0.01, significant difference. Conclusions DU-GERD occurs on the basis of chronic duodenal ulcer, which causes gastric motor dysfunction. Delayed gastric emptying leads to decreased function of the lower esophageal sphincter, and gastric reflux caused by long-term immersion of esophageal mucosa. Reflux esophagitis .