十二指腸潰瘍病患的胃竇測量之研究

以高雄醫學院外科因十二指腸潰瘍而迷走神經切斷術併部份胃切除術的連續46例胃標本為材料，來探討胃竇的計量及胃竇切除術和高選擇迷走神經切斷術時的胃漿膜側的解剖學標記(anatomical landmark)。術中，先將迷走神經胃竇分枝以黑絲線為記，術後，胃標本以蘇木精與伊紅染色(Hematoxylin-Eosinstain)，以光學顯微鏡鏡檢胃體竇境界(中間帶)並比較神經的相關位置，而有以下之結果： (1) 胃竇的大小，個別差異頗大，並隨年歲的增長，有向賁門側往上移的傾向。 (2) 胃體竇境界是胃底腺和幽門腺領域間的過渡移行帶，於胃小彎側最窄，往胃大彎側有擴寬的情形。且於小彎處與幽門的距離最遠，而往前後壁，呈對性的縮短。 (3) 迷走神經胃竇第一分枝可為胃小彎之組織學胃體竇境界的解剖學標記。 (4) 本研究中，93.5%的病例，小彎側胃體竇境界位於胃竇第一分枝上下２公分，此可為胃竇切除術時的參考值。但胃大彎側無解剖學標記可尋。 (5) 胃標本經10%福馬林固定後久縮小比例為0.7至0.9。

關鍵字

無資料

並列摘要

The extent of the gastric antrum in duodenal ulcer patients and the relationship between the first antral branch of the vagal nerve and proximal delimitation of antrum were examined usin resected gastric specimens of 46 duodenal ulcer patients. It has been demonstrated that: (1) There was a variable extent of measured distance from the pyloric ring to the antrum-corpus boundary (intermediate zone), and it ascended with age along the lesser curvature. (2) The intermediate zone was a transitional change of the fundic and pyloric gland area. The change on the lesser curvature was abrupt, but on the greater curvature it was gradual. It displace distally on the greater curvature, and was found to be symmetrical on the anterior and posterior walls. (3) The proximal delimitation of the antrum lay on the lesser curvature where the first antral branch of the vagal nerve reached the lesser curvature topographically. (4) At the lesser curvature, the antrum-corpus boundary was found to be located within ±2 cm from the first antral branch in 93.5% of the cases. It may be a useful landmark to decide the proximal boundary of gastric antrum while performing antrectomy. (5) The shrinkage factor for specimens after 10% formalin fixation appeared to be between 0.7 and 0.9.

並列關鍵字

histological antrum of the stomach ； antrectomy

國際替代計量

十二指腸潰瘍病患的胃竇測量之研究

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