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消化性溃疡病人手术后,许多病人出现胆汁反流和胆汁性呕吐。内科治疗(包括应用消胆胺)效果不满意,因此采用Roux-en-Y重建手术以缓解症状。过去选择作这种手术的病例,主要是有上腹疼痛而不能被硷性药物或食物所能缓解者;胃酸缺乏或有胃炎者。作者认为过去对病例的选择限制性太大,对胆汁反流没有作定量的测定。本文报道对18例消化性溃疡术后出现胆汁反流引起消化不良和呕吐的病人,作了Roux-en-Y胆汁转向手术。1年后发现原先空腹胆汁反流(FBR)>12Cumol/小时的患者,则术后可获较好效果,上腹疼痛的缓解亦较胆汁反流少的更明显。内窥镜检查发现胃粘膜红斑消失、充血改善,食管炎亦有明显改善。内窥
After peptic ulcer surgery, many patients have bile reflux and bile vomiting. Internal therapy, including the use of cholestyramine, was not satisfactory and Roux-en-Y reconstruction was used to relieve the symptoms. In the past, the cases that were chosen for such surgery were mainly those with upper abdominal pain that could not be relieved by alkaline drugs or food; those with achlorhydria or gastritis. The author believes that in the past the choice of cases is too restrictive, no quantitative determination of bile reflux. This paper reports 18 patients with peptic ulcer after bile reflux caused by dyspepsia and vomiting in patients with Roux-en-Y biliary steering surgery. One year later found that patients with previous fasting bile reflux (FBR)> 12Cumol / hour had better postoperative outcomes and less severe abdominal pain relief than bile reflux. Endoscopic examination found that gastric mucosa erythema disappeared, congestion improved, esophagitis also significantly improved. Endoscopy