胰十二指肠切除术后胃瘫28例临床分析  

Gastroparesis after Pancreatoduodenectomy:Analysis of 28 cases

作　　者：龚军[1] 俞小炯[1] 向光明[2] 郑振江[2] 刘续宝[2] 

机构地区：[1]四川省医学科学院.四川省人民医院肝胆胰外科,四川成都610072 [2]四川大学华西医院肝胆胰外科,四川成都610041

出　　处：《实用医院临床杂志》2011年第5期129-130,共2页Practical Journal of Clinical Medicine

摘　　要：目的探讨胰十二指肠切除术后胃瘫的病因、诊断和治疗。方法回顾性分析2006年1月至2010年6月胰十二指肠切除术后发生胃瘫的28例患者的临床资料。结果 28例患者均于术后21～56天(平均31.8天)通过保守治疗恢复胃动力,其中3周内恢复4例,4周内恢复11例,超过4周恢复者13例;治疗过程中无严重并发症及死亡病例,无再次手术者,3年随访无复发。结论 胰十二指肠切除术后胃瘫多发生于病情复杂、手术创伤大、手术时间长的患者。预防胰腺术后胃瘫,需要术前消除患者顾虑、加强营养、控制感染;术中操作要轻柔。治疗胃瘫,应该是以肠内营养(EN)为主的中西医结合的综合疗法。Objective To investigate the causes,diagnosis and treatment of gastroparesis after Pancreatoduodenectomy.Methods From January 2006 to June 2010,clinical data of 28 cases of gastroparesis after Pancreatoduodenectomy were analyzed retrospectively.Results All the patients were cured by expectant treatment 21~56 days（31.8 days on average） after Pancreatoduodenectomy.Four cases recovered within 3 weeks,11 cases within 4 weeks,and 13 cases after more than 4 weeks.There were no serious complications and death in the course of treatments,no re-surgery,and without recurrence in 3-year follow-up.Conclusions Gastroparesis after Pancreatoduodenectomy usually occurs in patients with complex diseases,serious surgical trauma and longer time operation.To prevent gastroparesis,we should eliminate nervousness of patients,enhance their nutrition and control infection before operation.The treatment methods should mainly include enteral nutrition and integrated traditional and western medicine.

关 键 词：胃瘫 胰十二指肠切除术 治疗 

分 类 号：R573[医药卫生—消化系统] R657.5[医药卫生—内科学]