胃手术后胃排空障碍的诊断和治疗  

The diagnosis and treatment for postoperative dysfunction of gastric emptying

作　　者：唐令超[1] 赵平[1] 丁志[1] 刘宝善[1] 

机构地区：[1]四川省肿瘤医院外科,四川成都610041

出　　处：《四川医学》2008年第9期1168-1170,共3页Sichuan Medical Journal

摘　　要：目的探讨胃手术后胃排空障碍的因素、诊断及治疗措施。方法回顾性分析1988年4月-2007年12月收治的胃手术患者1320例，其中73例胃手术后发生了胃排空障碍。结果胃手术后胃排空障碍多发生在胃手术后的3．12d，其中术后3～4d停止胃肠减压即出现症状者13例（17-8％）；术后5—7d进流质饮食后出现症状25例（34．2％）；术后12d由流质改为半流质饮食出现症状35例（47．9％）。本组患者并发有糖尿病、营养不良、贫血、腹水、幽门梗阻是可能的诱因，分别占38．3％、35．6％、32．8％、26．0％、28．7％。经对症处理绝大多数患者在3～6周症状消失，只有1例迁延达51d。结论胃手术后胃排空障碍多出现在胃术后的3—12d。影响的因素主要是糖尿病或营养不良。胃镜检查及同步放置肠内营养管对治疗有意义。对症处置均能治愈，不需要再次手术治疗。Objective To investigate the causes to postoperative dysfunction of gastric emptying, and discuss its diagnosis and treatments.Methods seventy-three cases complicated by gastric emptying diseases out of 1320 cases underwent gastric surgery from February 1988 to October 2007 were retrospectively reviewed. Results The dysfunction of gastric emptying appeared mostly in 3-12 days post operation. Among the 73 cases, 13 cases （ 17.8 % ） occurred within 3 - 4 days shortly after operation when stopping the gastrointestinal decompression;25 cases（34.2% ） occurred in 5 - 7 days post operation when starting of the liquid food;35 cases （47.9%） occurred 12 days or more post operation when feeding the semi-liquid food. Associated disorders as diabetes（ 38.3 % ）, malnutrition（ 35.6 % ）, anemia（ 32.8 % ）, ascites （26.0 % ）, and pyloric obstruction （28.7 % ） are the potential cause of this disease. The symptoms of most patients disappeared in 3 - 6 weeks through symptomatic therapy,while one case was prolonged to 51 days after surgery. Conclusion The dysfunction of gastric emptying occurred mostly in 3 - 12 days after surgery. The major causative diseases are diabetes and malnutrition, which could be managed by symptomatic treatments without operation.

关 键 词：胃手术 胃排空障碍 治疗 

分 类 号：R656.61[医药卫生—外科学]