根治性胃大部切除术后胃瘫15例临床分析

Clinical analysis of 15 cases with gastroparesis after radicalgastrectomy.

目的为探讨根治性远端胃大部切除术后胃瘫发生的病因，寻找诊断及治疗方法。方法以根治性胃大部切除术后发生胃瘫的１５例，对其发生率、发生时间、临床表现及诱发因素进行分析。结果除糖尿病外，术前流出道梗阻、胃肠毕Ⅱ式吻合病人的发病率较高。胃镜、Ｘ线检查，核素标记胃排空测定对胃瘫诊断有价值。经非手术治疗，在术后６周内一般都能恢复。结论胃镜检查时对残胃适度刺激（尤其在术后３周后）对胃瘫治疗有价值。

Objective Etiology,diagnosis and treatment of gastroparesis after radical gastrectomy were analzed. Methods Incidence,occurence time,clinical manifestations and precipitating factors were analyzed for 15 cases with gastroparesis after radical gastrectomy. Results Gastroparesis was more frequent in those patients who had a preoperative gastric outlet obstruction or after a Billroth type gastrojejunostomy or diabetic patients.Gastroscopy,X-ray and gastric emptying measurements of radio labeled meal are valuable in the diagnoses of gastroparesis.The gastric motility usually restores to nomal in 6 weeks postoperatively. Conclusion Adjuvant stimulation with gastroscopy,especially 3 weeks after surgery is helpful in the treatment of gastroparesis.Reoperation should be avoided.