腹部术后胃瘫综合征的诊治体会

Diagnosis and treatment of postoperative gastroparesis syndrome

目的探讨腹部术后胃瘫的诊断及治疗.方法总结16例腹部术后胃瘫患者的临床资料进行回顾性分析.结果该组病例中男11例,女5例;年龄36～85岁,平均(60.50±15.76)岁.术前长期流出道梗阻、恶性肿瘤、胆道疾病、胰十二指肠切除术后,胃大部切除术后的病人发病率高.胃镜、X线口服造影及核素胃排空试验对术后胃瘫的诊断有价值,经保守治疗后胃肠动力一般在术后4周内恢复.结论该病是一种功能性疾病,一旦诊断成立,采取促动力药物在内的保守治疗是治疗的有效方法,不宜盲目手术.

Objective: To analyze the diagnosis and treatment of postoperative gastroparesis syndrome (PGS). Methods: Retrospective analysis was performed on 16 cases of postoperative gastoparesis syndrome. Results: Among the 16 cases: 11 male and 5 female patients; aged from 36 to 85 years old, average (60.50±15.76) years old. Patients with preoperative gastric outlet occlusion for long-term, malignant tumor, disease of bile duct, pancreatoduodenectomy, subtotal gastrectomy undergone high incidence of PGS. Gastroscopy, X-ray and scintigraphic measurement of gastric emptying were valuabe in the diagnosis of gastroparesis. The gastic motility usually recovered within 6 weeks postoperatively. Conclusion: PGS is a functional disease. Conservative therapy such as gastrointestinal dynamic drug is the helpful therapy for the remission of PGS, and reoperation should be avoided.