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碱性反流性胃炎(胆汁性胃炎)是由于十二指肠内容物致胃粘膜损伤的临床综合征。该损伤由胆汁酸、胰酶抑或碱引起仍有争论。碱性反流性胃炎常发生于胃手术后,因其破坏幽门括约肌的保护功能,最常见于胃切除术后(Billroth Ⅰ或Ⅱ),也见于单纯性胃空肠吻合术或幽门成形术后。本综合征也见于胆囊切除术后和壶腹括约肌成形术后。在后一种情况,认为胰与胆道的分泌物持续进入十二指肠。因此,十二指肠内容物未被食物吸附,并大量反流入胃。无胃或胆道手术史的病人,也可发生碱性反流性胃炎。
Alkaline reflux gastritis (biliary gastritis) is a clinical syndrome due to gastric mucosal damage caused by duodenal contents. The damage is caused by bile acids, trypsin, or bases and remains controversial. Alkaline reflux gastritis often occurs after gastric surgery, because of its protective function of pyloric sphincter damage, the most common after gastrectomy (Billroth Ⅰ or Ⅱ), also found in simple gastrojejunostomy or pyloroplasty. The syndrome is also found after cholecystectomy and ampullary sphincteroplasty. In the latter case, pancreatic and biliary secretions persist into the duodenum. As a result, duodenal contents are not adsorbed by the food and are heavily refluxed into the stomach. Allergic gastritis may also occur in patients without a history of gastric or biliary surgery.