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研究先天性肥厚性幽门梗阻(HPS),对患儿胃液中PGE_2术前、术后的变化,以探讨其与HPS发病的关系。测定HPS患儿术前、术后24小时、术后72小时胃液中PGE_2和PH值及其相关关系,并设立正常对照组。结果显示:HPS组术前PGE_2测定(220.10±68.20mg/L)明显高于对照组(98.75±50.20mg/L,P<0.01);术后24小时(150.33±45.10mg/L)明显下降(P<0.05),72小时(102.25±40.55mg/L)降至正常(P>0.05)。胃液pH值术前、术后24小时、72小时分别为1.95±0.45、2.25±0.38、3.15±0.42;而对照组3.10±0.55,术前明显低于对照组(P<0.01),术后很快升高,72小时与对照组无差异(P>0.05)。PGE_2水平与术前、术后胃液为pH值呈负相关(R=0.73),即与胃酸水平呈正相关。结论:HPS患儿胃液中PGE_2水平明显高于对照组,术后显著下降;PGE_2与胃液pH值呈负相关,即胃酸浓度越高,PGE_2分泌越增加。说明,PGE_2的升高是由胃酸分泌增加引起的继发现象,与HPS的发病无关。HPS患儿幽门梗阻、胃排空延迟,刺激胃酸分泌从而引起PGE_2升高,反之梗阻解除后PGE_2下降。
To study the congenital hypertrophic pyloric obstruction (HPS), the changes of PGE_2 in gastric juice before and after surgery in children to explore its relationship with the pathogenesis of HPS. The levels of PGE 2 and PH in gastric juice of HPS patients before operation, 24 hours after operation and 72 hours after operation were determined, and the normal control group was established. The results showed that the preoperative PGE_2 level in HPS group was significantly higher than that in control group (220.10 ± 68.20mg / L, 98.75 ± 50.20mg / L, P <0.01), and significantly lower at 24 hours after operation (150.33 ± 45.10mg / L) P <0.05), 72 hours (102.25 ± 40.55 mg / L) to normal (P> 0.05). The pH value of gastric juice was 1.95 ± 0.45, 2.25 ± 0.38 and 3.15 ± 0.42 at 24 hours and 72 hours after operation, while it was 3.10 ± 0.55 in control group, which was significantly lower than that in control group before operation (P <0.01) Fast rise, 72 hours no difference with the control group (P> 0.05). The level of PGE_2 was negatively correlated with preoperative and postoperative gastric pH value (R = 0.73), which was positively correlated with gastric acid level. CONCLUSION: The level of PGE_2 in gastric juice of HPS children is significantly higher than that of control group, and the level of PGE_2 is significantly decreased after operation. PGE_2 is negatively correlated with the pH value of gastric juice, that is, the higher the gastric acid concentration, the more the secretion of PGE_2. Description, PGE 2 increased gastric acid secretion caused by increased secondary phenomenon, has nothing to do with the incidence of HPS. Hypobaric pyloric obstruction in children, delayed gastric emptying, stimulate gastric acid secretion caused by increased PGE_2, conversely obstruction after lifting PGE_2 decreased.