胃手术后梗阻并发症及处理  

Management of obstructions after gastric operation

作　　者：毕建威[1] 聂明明[1] 

机构地区：[1]第二军医大学附属长海医院胃肠外科,上海200433

出　　处：《中国实用外科杂志》2013年第4期309-312,共4页Chinese Journal of Practical Surgery

摘　　要：胃手术有关的梗阻并发症主要包括输入袢梗阻、输出袢梗阻、内疝性梗阻及残胃排空障碍。输入段肠袢梗阻一般均需手术治疗,对于完全梗阻或出现绞窄征象者应尽早手术。输出袢肠段梗阻的处理没有输入袢梗阻那样急迫,如无腹膜炎征象或上消化道出血的情况,一般可先按肠梗阻治疗原则治疗,如经保守治疗无好转,应行手术治疗。内疝性梗阻是胃手术后一种特殊类型的肠梗阻,一般都需手术治疗。残胃排空障碍属于功能性并发症,而非机械性梗阻,诊断明确后应坚持保守治疗。The issues is on diagnosis and treatment tor obstruction which are specially associated whit gastric operation. These complications include obstructions of afferent loop obstructions and efferent loop obstruction, and internal hernias, gastroparesis. Operation is always needed in afferent loop obstructions, and as soon as possible in complete obstruction or strangulated obstruction. The management of efferent loop obstruction is not imperative as that of afferent loop obstructions. If there are no presentation of peritonitis or upper gastrointestinal hemorrhage, the principle of treatment of efferent loop obstruction identify with that of ileus. Operative intervention is necessary without improvement during conservative treatment. Internal hernia is a special type of obstruction after gastric operation, and is always needed operative intervention. Gastroparesis is a functional gastric outlet obstruction with no mechanical causes. After the diagnosis of gastroparesis confirmed, it must treated conservatively.

关 键 词：胃手术 梗阻 

分 类 号：R6[医药卫生—外科学]