根治性胃大部切除术后胃瘫综合征10例诊疗探讨

Discussion on the Diagnosis and Treatment of Gastroparesis Syndrome after Radical Subtotal Gastrectomy in 10 Cases

目的探讨根治性胃大部切除术后胃瘫综合征的诊疗。方法回顾我院自2001年11月-2009年10月共施行胃癌根治术291例病历资料。结果291例胃癌根治术患者，其中近端胃癌根治术86例，远端胃癌根治术168例，共发生胃瘫10例（39％），经综合治疗术后2-3周内4例恢复胃动力，胃管引流量逐渐减少至拔除。余6例均行胃镜刺激珐胃及吻合口，2例很快恢复胃动力，4例5周以上恢复胃动力，时间最长1例术后46d恢复。10例患者均获治愈，元1例手术。结论根治性胃大部切除术后胃瘫综合征发生率低，原因尚不明，经综合治疗均可治愈。

Objective To discuss the diagnosis of Gastroparesis Syndrome after Radical Subtotal Gastrectomy. Method Reviewing the medical records of 291 cases who received the radical operation for carcinoma of stomach from November 2001 to October 2009. Results Among the 291 patients who receiving radical operation for carcinoma of stomach, 86 cases received proximal gastric cancer surgery, while 168 eases received distal gastric cancer surgery, and 10 patients suffered from gastroparesis syndrome （3.9%）. After receiving comprehensive treatment, 4 patients restored their gastric motility 2 or 3 weeks later. The amount of drainage in gastric tube gradually decreased and the gastric tube was removed at last. Stimulating the remnant stomach endoscopy and stoma in other 6 cases, 2 eases restored their gastric motility in a short time, 4 eases restored their gastric motility after 5 weeks, and the slowest recovery case restored his gastric motility after 46 days. 10 patients were eared and without re-surgery. Conclusion Gastroparesis Syndrome after radical subtotal gastrectomy has low incidence, the eanse of this disease is not clear, and can be cured by comprehensive treatment.