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保留幽门胰十二指肠切除术后胃排空障碍 被引量:17

Postoperative disturbed gastric empting in pylorus preserved pancreaticoduodenectomy
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摘要 作者对保留幽门胰十二指肠切除术(PPPD)术后胃排空障碍(DGE)的发生原因、临床表现及治疗进行了分析讨论。74例PPPD术后有28例发生DGE,发生率为37.8%,平均胃减压时间为17.4天。临床表现以腹胀、呃逆、恶心呕吐为主,多数患者胃内残液量在500ml以上。术中清扫导致幽门和十二指肠近端轻度的供血障碍是发生DGE的主要原因,手术后腹内感染等并发症可加重DGE的临床表现并延缓胃蠕动的恢复。全静脉营养和肠道营养可保证DGE期间机体营养的需求,红霉素对缓解DGE的症状有一定的作用。 Abstract: In this study, 28 cases suffered postoperative disturbed gastric empting (DGE) in a total of 74 pylorus preserved pancreaticoduodenectomes (PPPD) with occurence rate of 37. 8%. Nasogastric tube was left for an average of 17. 4 days. Abdominal distrntion, hiccup,nausea,and vomit were among the most common clinical features,and gastric retention volume was lager than 500ml in most patients. Ischemia in the pylorus caused by surgery could be the etiology of DGE which further aggravated by postoperative intraabdominal infection. TPN or EEN is important and erythromycin may help in improving GI peristalsis.
出处 《普外临床》 CSCD 1997年第1期51-53,58,共4页
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