胃亜全摘Billroth I法術後の十二指腸残胃食道逆流現象と消化管運動

フォーマット:

論文(リポジトリ)

責任表示:

武田, 信夫

出版情報:

新潟医学会, 1992-12

掲載情報:

新潟医学会雑誌 — 新潟医学会雑誌

ISSN:

00290440      

著者名:

武田, 信夫  

巻:

106

通号:

12

開始ページ:

1146

終了ページ:

1154

概要:

Simultaneous measurments of distal esophageal pH and gastroduodenal motor activity were recorded for 8 hrs in the night in 21 patients undergoing subtotal gastrectomy B-I anastomosis for gastric cancer. They were divided into 3 groups by Sa … vary-Miller classifications. Group A consisted of 9 patients without esophagitis, Group B；8 with mild esophagitis, Group C；4 with severe esophagitis. Mean esophageal pH (A：5.8, B：6.6, C：7.1) and percent time of alkaline reflux in the esophagus (A：0.6%, B：12.4%, C：58.4%) were significantly correlated with the severity of esophageal mucosal damage. The manometric study showed fasting cyclic motor activity in the duodenum but these activities were not recognized in the remnant stomach. Periodic duodenal motor activity was well correlated with alkaline reflux to the esophagus. Five patients in group B or C complained heartburn 12 times (B：8, C：4). However, none of them complained heartburn during periods of duodenal motor quiescence. Occurrence of symptoms with sudden alkalizing in esophageal pH were temporally associated with duodenal phase III in group B patients (6 times). However in group C, the symptoms occurred during phase II activity since esophageal pH has already been alkalized. From these results, it is suggested that fasting duodenal motor activity plays an important role in gastroesophageal reflux. 続きを見る

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