• 第三軍醫(yī)大學(xué)大坪醫(yī)院野戰(zhàn)外科研究所普通外科（重慶400042）;

目的 了解高選迷走神經(jīng)切斷術(shù)加胃竇粘膜切除術(shù)（HSVMA）和單純高選迷走神經(jīng)切斷術(shù)（HSV）對(duì)胃竇運(yùn)動(dòng)功能的影響。方法將18只犬隨機(jī)均分成3組（對(duì)照組、HSV組、HSVMA組），術(shù)后4~6個(gè)月測(cè)胃排空時(shí)間、胃竇肌電活動(dòng)及胃竇壓。48例十二指腸潰瘍患者隨機(jī)分成HSVMA組（28例）和HSV組（20例），術(shù)后4~6個(gè)月行胃排空、胃電圖(EGG)頻率及振幅和胃酸檢查，并與術(shù)前水平作比較。結(jié)果X線鋇餐檢查發(fā)現(xiàn)術(shù)后兩組患者及犬的胃和十二指腸形態(tài)正常，胃蠕動(dòng)波清晰可見(jiàn)。在犬HSVMA組，胃的初排及排空時(shí)間分別為（5.0±0.06） min及（4.0±0.4） h，和對(duì)照組及HSV組相近（P gt;0.05）。犬HSVMA組胃竇肌電動(dòng)作電位頻率是（3.11±0.65）次/分，患者HSVMA組胃電圖頻率為（3.25±0.75）次/分，均明顯低于相應(yīng)對(duì)照組及HSV組（P＜0.05）。肌注5肽胃泌素或進(jìn)餐能明顯增加胃竇壓及胃電圖振幅。胃酸分泌HSVMA組及HSV組相似，但均明顯低于對(duì)照組。結(jié)論盡管胃肌電頻率稍低，但HSVMA后胃竇運(yùn)動(dòng)功能接近正常。因此，HSVMA是治療十二指腸潰瘍的一種可選擇術(shù)式。

引用本文： 文亞淵,王代科,劉寶華. 高選迷切加胃竇粘膜切除術(shù)及單純高選迷切對(duì)胃運(yùn)動(dòng)功能的影響. 中國(guó)普外基礎(chǔ)與臨床雜志, 2002, 9(2): 105-107. doi: 復(fù)制

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  2. 2. Schirner BS. Current status of proximal gastric vagotomy \[J\]. Ann Surg， 1989; 209(2)∶131.
  3. 3. Johnston GW, Spencer EF, Wilkinson AJ, et al. Proximal gastric vagotomy: followup at 10-20 years \[J\]. Br J Surg， 1991; 78(1)∶20.
  4. 4. 余佩武,王代科.高選迷切加胃竇粘膜切除術(shù)治療十二指腸潰瘍 \[J\].實(shí)用外科雜志，1990; 10(1)∶82.
  5. 5. Gidda JS. Influence of vagus on electrical activity of opossum small intestine \[J\]. Am J Physiol， 1980; 238（6）∶466.
  6. 6. Paimela H, Hallikainen D, Ahonen J, et al. The prognostic significance of radiological determined gastric emptying time before proximal gastric vagotomy \[J\]. Acta Chir Scand，1986; 152(10)∶611.
  7. 7. Amdrup BM, Crifftth CA. Selective vagotomy of the parietal cell mass: Part II: with suprapyloric mucosal antrectomy and suprapyoric antral resection \[J\]. Ann Surg，1969; 170(2)∶215.
  8. 8. Richter HM, Kekky KA, Go VLM. Proximal gastric vagotomy and mucosal antrectomy: effect on gastric acid secretion. Plasma gastrin and experimental ulcerogenesis in the dog \[J\]. Surgery， 1987; 101(4)∶623.
  9. 9. Kramberg O. Proximal gastric vagotomy with syorapyloric mucosal antrectomy for duodenal ulcer \[J\]. Acta Chir Scand， 1977; 143(2)∶163.
  10. 10. Kelly KA, Code CF. Canine gastric pacemaker \[J\]. Am J Physiol， 1971; 220(1)∶112.
  11. 11. Becker JM. Proximal gastric vagotomy and mucosal antrectomy: A possible operative approach to duodenal ulcer \[J\]. Surgery， 1983; 94(1)∶58.
  12. 12. Zhou L. Electrogastric activity. In： Zhou L, ed. Gastroenterology \[M\]. Beijing: Science Publish House， 1991∶331-342.