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报告用改良Golisher高选择性迷走神经切断术治疗球部溃疡100例、复合性溃疡79例及伴出血、梗阻、穿孔的球部溃疡38例,疗效满意,随访3~20年,并发症少,复发率<2%,按Visick分级优良率84%。作者认为:正确选择适应证;术中除保留鸦爪支、肝胆腹腔支、迷走神经主干外,应剥光食管下端5~7cm,完全切断前后主干向胃发出的分支和角切迹对应大弯侧胃网膜血管8~10cm。操作仔细、规范,防止遗漏是手术成功的关键。对复发病例的再手术要针对梗阻、复发溃疡合理选择术式,高选择性迷走神经切断术加胃窦粘膜切除术是较为理想的术式,复发率更低,效果好。
Report with modified Golisher highly selective vagotomy in the treatment of ulcer in 100 cases, 79 cases of combined ulcers and hemorrhage, obstruction, perforation of the ball ulcer in 38 cases, with satisfactory results, followed up for 3 to 20 years, fewer complications and relapse Rate <2%, according to Visick grading rate of 84%. The author believes that: the correct choice of indications; surgery in addition to retaining the crow claw, liver and gallbladder abdominal branches, the vagus nerve trunk should be stripped esophageal lower end 5 ~ 7cm, completely cut off before and after the main trunk to the stomach issued branches and corner notch corresponding to the bend side of the stomach Omentum vascular 8 ~ 10cm. Careful operation, norms, to prevent missing is the key to the success of the operation. The recurrence of cases of reoperation should be targeted at obstruction, a reasonable choice of recurrent ulcer surgery, high selective vagotomy and antral mucosal resection is an ideal surgical procedure, the recurrence rate is lower, the effect is good.