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目的：观察壁细胞迷走神经切断术加修补术，治疗幽门十二指肠溃疡穿孔的临床效果和实用价值。方法：纤维胃镜检查溃疡愈合情况，测定基础胃酸（ＢＡＯ），五肽胃泌素刺激胃酸分泌量（ＰＭＡＯ），高峰酸（ＰＡＯ）与择期十二指肠溃疡患者术前进行统计学分析。结果：壁细胞迷走神经切断术加修补术治疗的２２例幽门、十二指肠溃疡穿孔患者术后无并发症，术后２～３周纤维胃镜检查溃疡完全愈合１３例，部分愈合９例。经６月～５年随访，与择期十二指肠溃疡患者术前相比，ＢＡＯ下降８３％，ＰＭＡＯ下降６１％，ＰＡＯ下降５６％，两组间差异均显著（Ｐ＜０．０１）。远期疗效属ＶｉｓｉｃｋⅠ级和Ⅱ级占８６．４％，溃疡复发２例，经药物治疗后痊愈。结论：壁细胞迷走神经切断术加修补术破坏性小，安全性高，临床效果好，尤其适合基层医院采用。
Objective: To observe the clinical effect and practical value of parietal cell vagotomy and repair for the treatment of pyloric duodenal ulcer perforation. Methods: Gastric endoscopy was used to detect the healing of ulcer. The basal gastric acid (BAO), pentagastrin-stimulated gastric acid secretion (PMAO), peak acid (PAO) and elective duodenal ulcer were measured before operation. RESULTS: Twenty-two cases of pyloric and duodenal ulcer perforation treated by parietal cell vagotomy and repair had no postoperative complications. Thirteen cases were healed completely by gastroscopy and 9 cases were partially healed by fiberoptic endoscopy 2 ~ 3 weeks after operation. After 6 months to 5 years of follow-up, BAO decreased 83%, PMAO decreased 61% and PAO decreased 56% compared with preoperative duodenal ulcer patients. There was significant difference between the two groups (P <0.01). The long-term efficacy is Visick Ⅰ and Ⅱ grade accounted for 86.4%, ulcer recurrence in 2 cases, recovered after drug treatment. Conclusions: Parietal cell vagotomy and repair are less destructive, safe and have good clinical effect, especially for primary hospital.