全胃切除术后为什么缺乏维生素B12 闫志峰 山西省肿瘤医院 скачать в хорошем качестве

全胃切除术后为什么缺乏维生素B12 闫志峰 山西省肿瘤医院

全胃切除术后为什么缺乏维生素B12 闫志峰 山西省肿瘤医院 全胃切除术后很长一段时间内维生素B12缺乏并不明显，因为内因子分泌细胞和盐酸，胃蛋白酶分泌细胞的丢失导致维生素B12的吸收障碍发展为贫血，平均时间为5年，一般范围是2到1年，在部分胃切除术后，开始几年内并不经常发生维生素B12的缺乏，随着时间的推移，残余胃发生萎缩性胃炎，并成为晚期维生素B12缺乏的主要原因，维生素B12的缺乏常见于毕2式胃切除术后，对细菌的过度繁殖综合征的患者，细菌内大量吸收钴胺素，从而在回肠内的吸收量下降，另细菌可产生大量的叶酸等，因此一般不存在叶酸的缺乏，因此在叶酸补充不足而血清或红细胞叶酸呈高水平时，可提示小肠细菌过度繁殖。 Why lack of vitamin B12 after total gastrectomy Vitamin B12 deficiency was not obvious for a long time after total gastrectomy, Because it secretes cells and hydrochloric acid, The loss of pepsin secreting cells leads to the development of anemia, The average time is 5 years, The general range is 2 to 1 year, After partial gastrectomy, Vitamin B12 deficiency did not occur frequently in the first few years, as time goes on, Atrophic gastritis occurs in the remnant stomach, And become the main reason of the late vitamin B12 deficiency, The deficiency of vitamin B12 is common after Pythagorean gastrectomy, In patients with bacterial overgrowth syndrome, Bacteria absorb a lot of cobalamin, So the absorption in ileum decreased, In addition, bacteria can produce a lot of folate, Therefore, there is generally no lack of folate, Therefore, when the folate supplement is insufficient and the folate level in serum or erythrocytes is high, It may be suggested that the bacteria in the small intestine over propagate.