非胃大部切除手术后胃瘫综合征的诊治

Treatment and diagnosis of non-postsurgical gastroparesis syndrome

目的探讨非胃大部切除手术后胃瘫综合征(PGS)的诊治,旨在提高疗效,改善患者生活质量。方法 1998年2月至2009年2月共收治腹部非胃大部切除术后PGS 13例,其中男9例,女4例。采用保守对症治疗,予以禁食,持续胃肠减压,维持水电解质和酸碱平衡,纠正贫血和低蛋白血症,给予甲氧氯普胺,多s潘立酮,红霉素,西沙必利,甲基硫酸新斯的明,并给予心理辅导。结果 13例患者经保守治疗7～20天出现明显饥饿感,胃肠减压量明显减少(小于300 ml/日),夹管亦未再出现上腹饱胀呕吐等现象,胃功能恢复。本组中有3例恢复较慢,其中2例胃镜下置管后1天胃功能即恢复。结论保守对症治疗对非胃大部切除手术后胃瘫综合征具有良好的疗效,对于恢复较慢者要及时实施手术。

Objective To investigate the treatment and diagnosis of non-gastrectomy for postsurgical gastroparesis syndrome.Methods 13 PGS patients were treated with conservative symptomatic treatment,continuous gastrointestinal decompression,maintenance of water and electrolyte and acid-base balance,correct anemia and hypoproteinemia,and metoclopramide,domperidone,erythromycin,cisapride,methyl neostigmine sulfate,and psychological counseling.Results After 7 to 20 days conservative treatment,hunger,gastrointestinal decompression were significantly reduced.The daily were less than 300ml,folder management nor the recurrence of the phenomenon of bloating and vomiting,stomach function.3 patients recovered slowly,two cases of endoscopic gastric tube 1 day after the function resumed.Conclusion It is effective to treat non-gastrectomy gastroparesis syndrome with conservative symptomatic treatment.