食道癌术后胸胃排空障碍临床分析

Clinical Analysis of Disturbance of Postoperative Intrathoracic Gastric Emptying in Esophageal Cancer

目的：探讨食道癌术后胸胃排空障碍的诊断以及合理治疗方法。方法：我院1996年3月至2011年10月共收治了465例食管癌的患者,其中15例被诊断为胸胃排空障碍,按照目前鉴别方法,7例为功能性胸胃排空障碍,接受保守治疗,8例为机械性胸胃排空障碍,接受二次手术治疗。结果：7例功能性胸胃排空障碍患者经过保守治疗（3~10）d后全部治愈。8例机械性胸胃排空障碍患者经过二次手术后恶心、呕吐症状消失,胃液引流量较术前减少,胸胃功能逐渐恢复,补钾量较二次手术前减少,且术后无手术并发症、无死亡。二次手术后患者的胸胃排空明显改善,具有统计学差异（P〈0.05）。结论：胸胃排空障碍多为机械性原因导致,可通过改良食道癌手术方法预防,另外,目前对胸胃排空障碍的诊断与鉴别方法较为准确,应给予推广应用,通过保守治疗与二次手术治疗可有效治疗胸胃排空障碍。

Objective：To study the diagnosis and treatment of disturbance of intrathoracic gastric emptying after resection of gastric cardial cancer.Methods：2 069 patients with cardiac cancer received by our hospital from March 2000 to October 2011 underwent operation treatment.40 patients was diagnose with delayed gastric emptying after operation,in which 19 patients were fuctional and received expectant treatment,21 patients were mechanical and received the second operation treatment.Results：19 patients received expectant treatment were all cured after（3～10） days.21 patients received the second operation treatment were obviously improved（P〈0.05）.Conclusion：To prevent the obstructive gastric emptying disorder,surgical technique should be considered carefully during operation.The current standard of the diagnosis and distinguish of delayed gastric emptying is somewhat correct,according to which,expectant treatment together with may be good for the treatment of delayed gastric emptying.