天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (9): 965-968.doi: 10.11958/20170283

• 临床研究 • 上一篇    下一篇

切除幽门窦的胃转流术后胃泌素 17、胃蛋白酶原变化及对吻合口溃疡发生的影响

李洁 1，孙岩 1，苏伟 1，陈坤 1，孙成哲 2   

  1. 1 吉化集团公司总医院普外科（邮编 132000），2 电诊科
  • 收稿日期:2017-03-06 修回日期:2017-06-09 出版日期:2017-09-15 发布日期:2017-09-25
  • 通讯作者: 李洁 E-mail:40491732@qq.com

Effects of gastrin 17 and pepsinogen on anastomotic ulcer after gastric bypass surgery for resection of pyloric antrum

LI Jie1, SUN Yan1, SU Wei1, CHEN Kun1, SUN Cheng-zhe2   

  • Received:2017-03-06 Revised:2017-06-09 Published:2017-09-15 Online:2017-09-25

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摘要： 摘要：目的 研究切除及保留幽门窦的胃转流术后胃泌素17（G17）、胃蛋白酶原Ⅰ（PGⅠ）、胃蛋白酶原Ⅱ（PGⅡ）、PGⅠ/PGⅡ与吻合口溃疡发生的相关性。方法 选择2013年10月— 2015年10月我院施行胃转流手术的患者63例，将其分为切除幽门窦组33例与保留幽门窦组30例。采用酶联免疫吸附试验检测术后1个月、6个月、12个月G17、PGⅠ、PGⅡ、PGⅠ/PGⅡ，分析上述指标与术后吻合口溃疡发生的相关性。结果 切除幽门窦组病例G17在术后第6个月、12个月时与保留幽门窦组相比明显降低（P＜0.05）；PGⅠ、PGⅡ在术后第12个月时与保留幽门窦组相比明显降低（P＜0.05）；PGⅠ/PGⅡ在术后1个月、6个月、12个月时与保留幽门窦组相比，水平差异均无统计学意义（P＞0.05）；术后吻合口溃疡发生率与保留幽门窦组相比无统计学意义（P＞0.05）。结论 切除幽门窦的胃转流术可减少术后G17、PGⅠ、PGⅡ的分泌，但不能降低术后吻合口溃疡的发生率。

关键词: 幽门窦, 消化性溃疡, 胃泌素类, 胃蛋白酶原类, 胃转流术

Abstract: Abstract: Objective To study the changes of gastrin 17 (G17) and pepsinogen (PG) after gastric bypass surgery in gastric antrum resection, and the influences of different surgical methods on postoperative peptic ulcer. Methods Clinical data of 63 patients with gastric bypass surgery in our hospital from October 2013 to October 2015 were divided into resection of pyloric antrum group (n=33) and preserved pyloric antrum group (n=30). The values of G17, PGⅠ, PGⅡ and PGⅠ/PGⅡ were detected by enzyme linked immunosorbent assay at 1 month, 6 months and 12 months after operation. The correlation between the different surgical methods and the incidence of peptic ulcer was analyzed between two groups. Results The G17 levels were significantly decreased in resection of pyloric antrum group 6 and 12 months after operation than those in preserved pyloric antrum group (P＜0.05). Compared with preserved pyloric antrum group，PG Ⅰ and PG Ⅱ levels was significantly decreased 12 months after operation (P＜0.05). There was no significant difference in the ratio PGⅠ/PGⅡ at 1 month, 6 months and 12 months after operation between two groups (P＞0.05). There was no significant difference in postoperative peptic ulcer between two groups (P＞0.05). Conclusion Gastric bypass after resection of the pyloric antrum can reduce the postoperative secretion of G17, PGⅠ and PGⅡ, but which can not reduce the incidence of postoperative anastomotic ulcer.

Key words: pyloric antrum, peptic ulcer, gastrins, pepsinogens, gastric bypass