24小时动态胃pH监测在残胃黏膜泌酸功能中的研究

Clinical research of acid secreting function in patients with gastric stump

关键词:  24 h动态胃pH监测  残胃  幽门螺杆菌

Key words:  24 h pH monitoring  gastric stump  helicobacter pylori

摘要:

［目的］ 研究胃远端部分切除术后患者泌酸功能及其与黏膜病理改变和幽门螺杆菌（Hp）感染的相关性。［方法］采用24 h pH监测仪测定51例残胃患者空腹胃内pH值，根据24 h胃内平均pH值分为低泌酸组（pH≥3）和正常泌酸组（pH＜3）。胃镜观察残胃黏膜以及Hp检测。［结果］低泌酸组患者35例，其中29例黏膜呈重度萎缩；正常泌酸组16例，其中4例呈重度黏膜炎症（P=0.006）。两组间Hp感染率无明显差异。62.7%的患者胃酸分泌减少，但却接受了抑酸药物治疗。［结论］24 h动态胃pH监测可有效评价残胃患者胃黏膜泌酸功能。残胃炎程度与黏膜泌酸功能有明显相关性。

Abstract:

［Objective］To investigate acid-secreting functional status of gastric stump and the clinical significance.［Methods］pH value of gastric stump in 24 hours were monitored. Gastric mucosa were observed by endoscopy and biopsy. Helicobacter pylori were examined.［Results］Thirty-five patients with partial gastrectomy show pH≥3 in 24 hours, including 29 with atrophic gastritis. 16 show pH＜3, including 4 with severe gastritis. There was no significant difference between the two groups. About 62.7% patients which have no or little capability to produce acid receive acid suppressing therapy.［Conclusions］Twenty-four hours pH monitoring is an efficient method to detect mucous acid secreting function in patients with gastric stump. The degree of gastritis correlates with acid secretion of mucosa. Many patients which have lost normal acid secreting function receive unnecessary acid suppressing treatment.