腹部手术后胃瘫综合征24例诊治分析

Diagnosis and Treatment of Postsurgical Gastroparalysis Syndrome After Abdominal Operation

[目的]探讨腹部手术后胃瘫综合征的发生原因、机制、诊断和治疗。[方法]回顾性分析1991年1月至2006年9月本院收治的24例腹部大手术后发生的胃瘫综合征患者的临床资料。[结果]胃切除术后发生胃瘫19例，非胃手术后发生胃瘫5例;均发生于术后5～11d。24例均行非手术治愈，治愈时间为13～31d，其中采用螺旋形鼻肠管进行肠内营养支持的患者恢复比肠外营养支持者提前。[结论]腹部手术后胃瘫综合征是由多种因素诱发的。上消化道造影及胃镜检查是诊断胃瘫的可靠方法。一般采用非手术疗法可治愈，采用螺旋形鼻肠管进行肠内营养有助于胃肠道功能的恢复。

[Objective]To study the etiology,pathogenesis,diagnosis and treatment of postsurgical gastroparalysis syndrome （PGS）after abdominal operation. [Methods]The clinical data of 24 cases with PGS from Jan 1991 to Sep 2006 were analyzed. [Results]There were 19 cases suffering PGS after gastrectomy, 5 cases after other abdominal operations within 5 - 11 days after operation. Twenty four patients were cured with nonoperative treatment. The curing time was within 13-31 days . The recovery time of gastrointestinal motion of PGS patients by enteral nutrition via spiral nasal intestinal tube was shorter than that by parenteral nutrition. [Conclusion]PGS is induced by multiple factors. Radiography of upper gastrointestinal tract and gastroscopy are main methods to diagnose PGS. The methods of nonoperation are effective to patients with PGS. Enteral nutrition via spiral nasal intestinal tube is a good method to recover gastrointestinal motion of PGS patients.