重型颅脑损伤并发胃瘫76例临床分析  

Clinical analysis on 76 patients with severe traumatic brain injury complicated with gastroparesis

作　　者：廖圣芳[1] 王玉差[1] 陈汉民[1] 吴国鑫[1] 张义王[1] 

机构地区：[1]解放军第180医院脑外科南京军区颅脑创伤救治中心,福建泉州362000

出　　处：《临床军医杂志》2013年第5期477-479,共3页Clinical Journal of Medical Officers

摘　　要：目的总结重型颅脑损伤并发胃瘫的临床特点及诊断和治疗原则。方法回顾分析76例重型颅脑损伤并发胃瘫的临床资料。结果本组有5例因颅脑损伤病情过重死亡,1例因误吸严重致呼吸窘迫综合征死亡,1例老年患者因误吸后肺部感染致呼吸衰竭死亡,无一例因消化道并发症死亡。有29例(38.16%)需行鼻肠管鼻饲营养。治疗2周内完全恢复48例(63.16%),第3周恢复19例(25.00%),仅2例(2.63%)在3周后恢复。结论重型颅脑损伤并发的胃瘫属功能性病变而非机械性梗阻,诊断主要依靠症状、体征结合胃镜或消化道造影检查,经非手术治疗均基本可以治愈,部分患者需行鼻肠管营养治疗。Objective To sum up the clinical characteristics and the diagnostic and therapeutic principle of severe traumatic brain injury complicated with gastroparesis. Methods The clinical data of 76 patients with severe traumatic brain injury complicated with gastroparesis were retrospectively analyzed. Results Of the patients who died, five died of over-severe cerebral trauma, one died of acute respiratory distress syndrome caused by aspiration, and one died of respiratory failure resulting from pulmonary infection after aspiration. None died of digestive tract complication. Twenty-nine patients （38.6%） needed feeding via naso-intestinal tube. With treatment, the patients who recovered within two weeks accounted for 63.13 % （n = 48 ）, those who recovered within the third week accounted for 25.00% （ n = 19）, and those who recovered beyond three weeks accounted for 2.63% （ n = 2）. Conclusion The gastroparesis complicating severe traumatic brain injury is considered as a functional disorder rather than mechanical obstruction. It is mainly on the basis of symptoms and signs in combination with gastroscopy or radiography that the diagnosis can be made. The conservative treatment （ including nasal feeding in some oatients） should be aDolied to the disorder.

关 键 词：颅脑损伤 胃瘫 

分 类 号：R651.15[医药卫生—外科学]