胃癌根治术后胃瘫综合征的诊断与治疗

Diagnosis and treatment of postsurgical gastroparesis syndrome after radical gastrectomy of gastric carcinoma

目的探讨胃癌根治切除术后胃瘫综合征的发病机理、发病率、诊断及治疗。方法对1990至2005年585例胃癌根治术后病例资料进行回顾性分析。结果585例中有24例出现胃瘫综合征表现,发生率为4.1%。所有病例经保守治疗后,10～38d内治愈。结论术后胃肠道运动的改变及吻合口水肿可能是胃排空障碍的主要原因,而高龄、肿瘤、营养不良、水电解质失衡、腹腔感染则是诱因。胃肠道造影及胃镜检查是诊断本病的重要方法。采取非手术保守治疗一般均可治愈。

Objective To explore the pathogenesis, morbidity, diagnosis and treatment of postsurgical gastroparesis syndrome after radical gastrectomy of gastric carcinoma. Methods A retrospective analysis of the data of 585 cases undergoing radical gastrectomy for gastric carcinoma was made. Results Postsurgical gastroparesis syndrome（PGS） occurred in 24 of 585 patients,the incidence being 4. 1%. All patients were cured within 10 -38 days by conservative therapy. Conclusion The main causes of PGS may be the paralytic changes of gastric motility and anastomotic edema, while the risk factors are advanced age, tumor, malnutrition, water-electrolyte imbalance, and abdominal infection. Gastrointestinal radiography and endoscopy are important diagnostic methods. Patients with PGS can be cured by conservative treatment.