老年人上腹部术后胃瘫的特点及治疗观察

The clinical features and treatment observe of elderly gastroplegia after upper abdominal surgery

目的探讨老年人上腹部术后胃瘫的特点及治疗效果。方法将92例老年人上腹部术后胃瘫患者随机分为观察组和对照组各46例。对照组仅予基础治疗,观察组在基础治疗的同时,采用76%泛影葡胺100ml进行胃管灌注,持续0.5h后排除,每天进行2次,直至患者胃动力恢复,观察患者临床特点,对比2组胃动力恢复时间。结果临床特点为多数患者表现有精神压力大、胃体完整性受损、手术时间长、全肠外营养持续时间≥3d、术后镇痛泵的应用、重症腹腔感染。观察组胃动力恢复时间为(17.02±14.67)d明显短于对照组的(28.31±8.14)d,差异有统计学意义(P<0.05)。结论治疗老年人腹部术后胃瘫的有效方法之一是非手术综合治疗,采用76%泛影葡胺进行胃管灌注,有利于缩短患者胃动力恢复时间。

Objective To discuss the clinical features and treatment effect of elderly gastroplegia after upper abdomi nal surgery. Methods 92 cases elderly patients with gastroplegia after upper abdominal surgery were randomly divided into observation group and control group ,each of 46 cases. Control group was treated by basic treatment, observation group, on the basis of control group, was given 76% meglumine diatrizoate 100ml until gastric motility recovered, gastric tube perfusion, elim ination after 0.5h,twice a day. After treatment,observed the clinical features,compared the recovery time of gastric motility of 2 groups. Results The clinical features contained massive mental stress, the integrity of the gastric body was damaged,longer operation time,TPN duration more than 3 days, the applications of postoperative analgesia pump, severe abdominal infection. The recovery time of gastric motility of observation group [ （ 17.02 ± 14. 67 ） d ] was shorter than that of control group [ （28.31 ± 8.14）d ], the difference was statistically significant（ P 〈 0.05 ）. Conclusion Non-surgical treatment is one of ef fective methods in treatment of elderly gastroplegia after upper abdominal surgery. 76% meglumine diatrizoate in gastric tube perfusion can reduce the recovery time of gastric motility.