胰腺手术后胃瘫13例诊治分析

Gastroparesis after pancreatic operation: a clinical analysis of 13 cases

目的探讨胰腺手术后胃瘫的病因、诊断和治疗。方法回顾性分析我院1986年～2004年571例胰腺手术后发生胃瘫的13例病人的临床资料。结果所有病人均经中西医结合保守疗法治愈。结论胰腺术后胃瘫多发生于病情复杂、手术创伤大、手术时间长的病人。预防胰腺术后胃瘫,需要术前消除病人顾虑、加强营养、控制感染;术中操作要轻柔,手术创面尽量要小。治疗胃瘫,应该是以肠内营养(EN)为主的中西医结合的综合疗法。对那些病情重、体质差、精神紧张,手术时间长、创伤大的病人,术中空肠营养造瘘、术后适时置放鼻肠管是防治胃瘫有效的措施。

Objective To investigate the causes, diagnosis, tre atment of gastroparesis after pancreatic operation. Methods The clinical data from 13 cases of gastroparesis after pancreatic operation were reviewed retrospectively. Results All the patients suffering from gastroparesis were cure d satisfactorily by non-surgical and traditional Chinese treatment. Conclusions Gastroparesis after pancreatic operation usually occurs in those patients whose diseases were complex, seriously-injured, longer time operation. To prevent gastroparesis,we should eliminate nervousness of patients, enhance their nutrition, control infection before operation. The treatment methods should include mainly EN and traditional Chinese medicine. It is a wise choice to apply naso-entric tube or a jejunostomy tube to prevent and treat gastroparesis.