食管癌切除术后胃排空障碍的防治  

Prevention and treatment of delayed gastric emptying after operation for esophageal carcinoma

作　　者：覃文超[1] 夏道奎[1] 吴真洁[1] 胡旭[1] 

机构地区：[1]三峡大学第一临床医学院宜昌市中心人民医院心胸外科,湖北省宜昌443003

出　　处：《中国基层医药》2013年第9期1345-1347,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 分析食管癌切除术后发生胃排空障碍的原因及防治措施。方法 对13例食管癌术后并发胃排空障碍患者的临床资料进行回顾性分析。结果 13例胃排空障碍均发生于术后第10天,其中10例保守治疗,3例机械性胃排空障碍手术治愈。结论 胃上提、牵拉等解剖位置变化是胃排空障碍的主要原因,迷走神经离断、术后未充分减压等因素也与胃排空障碍有关;手术操作技巧是引起机械性胃排空障碍的主要原因。功能性胃排空障碍行保守治疗;发生机械性胃排空障碍应尽早手术。Objective To investigate the cause,treatment and prevention of delayed gastric emptying （DGE） after operation for esophageal carcinoma.Methods The clinical data of 13 cases with DGE after operation for esophageal carcinoma were analyzed retrospectively.Results DGE occurred at 10th day after operation.10 cases with functional delayed gastric emptying（FDGE） recovered after conservative treatment.3 cases with mechanical delayed gastric emptying（MDGE） were given surgical treatment.Conclusions The anatomical displacement of stomach may be the main cause of DGE.DGE is also related to vagus nerve and postoperative inadequate gastrointestinal decompression.Clinical symptoms,X-ray barium meal radiography and gastroscopy examination are the important diagnostic method.Conservative treatment should be the first choice for FDGE.The use of some gastro-intestinal prokinetic drugs may have a beneficial effect on FDGE.Once the diagnosis of MDGE is established,surgical treatment should be performed as early as possible.The fully preoperative preparation,the precise and concise techniques in operation and postoperative appropriate management may decrease the occurrence of DGE.

关 键 词：胃肿瘤 胃切除术后综合症 治疗 

分 类 号：R735.1[医药卫生—肿瘤]