胃癌术后胃瘫并发韦尼克脑病的诊断及治疗

Diagnosis and treatment of wernicke encephalopathy associated with gastroplegia after gastric cancer surgery

目的探讨因胃癌术后胃瘫引发韦尼克脑病的病因、诊断和治疗方法。方法回顾性分析2000年8月至2010年12月收治的6例胃癌术后胃瘫并发韦尼克脑病患者的临床资料。结果胃癌患者816例的治疗过程中发生胃瘫32例(3.9%),在32例胃瘫中并发韦尼克脑病6例(18.8%),多发生在胃癌术后胃瘫后第1～2周。4例(66.7%)经及时诊断后补充维生素B1症状消失,2例(33.3%)因延误治疗而留有后遗症。结论胃癌术后胃瘫患者及时补充维生素B1是预防及治疗韦尼克脑病发生的关键。

Objective To investigate the cause, pathogenesis, diagnosis and treatment ofWernicke encephalopathy （WE） associated with gastroplegia after operation for gastric cancer. Methods Clinical data of 6 patients who had WE associated with gastroplegia after gastrectomy were analyzed retrospectively. Results In 816 patients with gastric cancer, 32 （3.9%） patients developed gastroplegia after operation. In the 32 patients with gastroplegia, 6 patients （ 18.8% ） developed WE within 2 weeks. Four patients with WE （66.7%） were treated successfully with vitamin B1 in time; however, 2 patients （33.3%） developed delayed sequelae due to misdiagnosis. Conclusions Supplement of vitamin B1 is proposed to prevent and treat WE associated with gastroplegia after gastrectomy.