腹部手术后胃瘫综合征的诊治分析

Diagnosis and treatment of postsurgical gastroparesis syndrome

目的:探讨手术后胃瘫综合征发生的病因,诊断方法和治疗手段。方法:分析28例腹部手术后出现胃瘫患者,分析其临床表现、发生时间、恢复时间和诱发因素。结果:高龄、接受全麻及近端胃大部切除术、术后应用镇痛泵的患者发病率高,临床表现、泛影葡胺造影检查及胃镜检查是诊断本病的主要手段;大部分患者经保守治疗,9周内恢复正常。结论:高龄、麻醉及手术方式、术后应用自控镇痛泵及精神因素与手术后胃瘫发生密切相关。综合保守治疗是治疗胃瘫的有效方法。

Objective：To approach the etiological factor,diagnostic method and therapeutic measure of postsurgical gastroparesis syndrome（PGS）.Methods： The clinical data of 28 patients with PGS were retrospectively reviewed.The clinical manifestation,occurrence time,recovery time and causative factor were analyzed.Results： The risk factors of PGS included the senility,general anesthesia,proximal subtotal gastrectomy and postoperative patient-controlled analgesia.The diagnosis of PGS was mainly based on the clinical manifestation,upper gastroen terography with meglumine diatrizoate and gastroscopy.Most of patients could be recovered by means of conservative treatment within 9 weeks.Conclusion： Senility,general anesthesia,surgical technique and patient-controlled analgesia after operation may be the high risk factors of PGS.Combined conservative treatment is effective for this disease.