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全世界行各类迷走神经切除术者已逾万例,但是对其疗效的判断问题尚未解决。胰岛素试验有许多不足之处,大组病例观察各类迷走神经切除术后胰岛素试验阳性率达30～50%。显然,这与临床资料不符,临床证实十二指肠溃疡各类迷走神经切除术后复发率仅6.5～11%。有作者报道胰岛素试验的判断标准竟有14种之多,而且有些是互相矛盾的,因此,对此试验的客观性可疑。术中pH试验可以检测迷走神经切除是否完全,但延长了手术时间,对预后和确定十二指肠溃疡复发的原因无价值。胃液分析结果亦有不足之处。 1973年提出用阿托品试验判断迷走神经切除后的远期效果,其优点是:(1)胃内pH测量能分别研究胃的两个分泌区(基底和幽门)的pH值。(2)评价胃
There are more than 10,000 cases of vagus nerve excision in the world, but the question of its efficacy has not yet been resolved. There are many shortcomings in the insulin test. A large group of patients observed a positive rate of 30-50% in the insulin test after vagotomy. Obviously, this is inconsistent with the clinical data, clinically confirmed that duodenal ulcer recurrence rate after vagotomy only 6.5 to 11%. Some authors have reported that there are as many as 14 kinds of judgments for insulin tests, and some are contradictory. Therefore, the objectivity of this test is doubtful. The intraoperative pH test can detect whether the vagotomy is complete, but it prolongs the operation time, which is of no value for the prognosis and the cause of the recurrence of duodenal ulcer. Gastric fluid analysis results also have deficiencies. In 1973, the atropine test was used to determine the long-term effects of vagal nerve resection. The advantages are: (1) The intragastric pH measurement can separately study the pH values of the two gastric secretory regions (basal and pyloric). (2) Evaluation of the stomach