胃大部切除术后残胃功能性排空障碍诊断和治疗

Diagnosis and Treatment of Functional Delayed Gastric Emptying after Subtotal Gastrectomy

目的:研究胃大部切除术后残胃功能性排空障碍(functiona l de layed gastric em pty ing,FDGE)的可能诱因及其诊断和治疗方法。方法:10 a来胃大部切除术257例在术后发生FDGE患者10例,分析其临床特点及诊治体会。结果:发现手术前有贫血、低蛋白血症及幽门梗阻的患者,FDGE发生率高。上消化道造影或胃镜检查均能明确诊断,所有患者均经保守治疗如调理饮食、药物、针刺和理疗而治愈。结论:术后FDGE经上消化道造影即可确诊,也是鉴别机械性梗阻的首选方法,术后FDGE一旦确诊应避免再次手术。

Objective：To study the possible risk factors of functional delayed gastric emptying （FDGE） after subtotal gastrectomy and its diagnosis and treatment. Methods ：Clinical characteristics and treatment of 10 patients with FDGE occurred after subtotal gastrectomy were analyzed. Results：FDGE more frequently happened in those patients with either anemia hypoproteinemia or pyloric obstruction before surgery. The definite diagnosis could be made by upper gastrointestinal radiography. All the 10 patients with FDGE after subtotal gastrectomy were healed with conservative treatment. Conclusion：Upper gastrointestinal radiography or gastroscopy was diagnostic method of the choice for FDGE and also for differential diagnosis with mechanical obstruction. Reoperation should be avoided in patients with FEGE after subtotal gastrectomy.