根治性胃大部切除术后胃瘫综合征的回顾性研究  

Clinical analysis of 20 cases with postsurgical gastroparesis syndrome after radical subtotal gastrectomy

作　　者：刘凤林[1] 秦新裕[1] 

机构地区：[1]复旦大学附属中山医院普通外科,上海200032

出　　处：《中华胃肠外科杂志》2002年第4期245-248,共4页Chinese Journal of Gastrointestinal Surgery

基　　金：国家自然科学基金资助项目(30070738)

摘　　要：目的探讨根治性远端胃大部切除术后胃瘫综合征(PGS)发生的病因、诊断方法、治疗手段和疗效。方法根治性远端胃大部切除术患者501例,术后出现PGS20例,分析其临床表现、发生时间、恢复时间和诱发因素。结果术前流出道梗阻和胃肠吻合方式是术后PGS的高危因素。胃镜、X线口服造影和核素标记胃排空测定对PGS的诊断有价值。经非手术治疗,术后PGS在术后6周内一般可以恢复。红霉素对PGS的疗效有明确的个体差异。结论胃镜检查时对残胃予以适度刺激有助于PGS的治疗,应尽量避免再次手术。Objective To analyze the etiology, diagnostic methods, treatment of postoperative gastroparesis syndrome (PGS) after radical subtotal gastrectomy. Methods Clinical data of 501 cases with radical distal subtotal gastrectomy were collected and among them, 20 cases with PGS were enrolled. The incidence, occurrence time, recovery time, clinical manifestations and risk factors for PGS were analyzed. Results Preoperative gastric outlet occlusion, and Billroth Ⅱ gastrojejunostomy were high risk factors for PGS in above cases. Gastroscopy, X ray and scintigraphic measurement of gastric emptying were valuable in the diagnosis of gastroparesis. The gastric motility usually recovered within 6 weeks postoperatively. The effects of erythromycin on PGS were different individually. Conclusions A suitable irritation to remnant stomach during gastroscopy examination is helpful for the remission of PGS, and reoperation should be avoided.

关 键 词：根治性胃大部切除术 胃瘫综合征 治疗 PGS 病因 诊断 

分 类 号：R656.61[医药卫生—外科学]