食管癌术后胃瘫12例临床诊治体会

Diagnosis and therapy of gastroparesis after esophageal carcinoma operation:A report of 12 cases

目的:探讨食管癌术后胃瘫的病因、诊断及治疗。方法:回顾性分析367例手术治疗食管癌患者的临床资料。结果:367例患者确诊食管癌术后胃瘫12例,患者表现为胃潴留,无明显腹痛,肛门排气大多正常。消化道造影见胃蠕动差,吻合口通畅。所有病例经胃肠减压,肠内营养支持,维持水电解质平衡,以及促进胃肠动力药物的应用,病情均得以缓解出院,全组无死亡病例。结论:食管癌术后胃瘫的诊断主要依据临床表现、消化道造影及胸部CT等检查,排除存在机械性梗阻后应积极采取以肠内营养为主的综合治疗以及胃肠动力促进剂等非手术治疗,可以保守治愈。

Objective：To explore the causes,diagnosis and treatment of gastroparesis after esophageal carcinoma operation.Methods：Clinical data of 367 patients who underwent the operation for esophageal carcinomain our depart- ment were retrospectively analyzed.Results：12 patients were diagnosed with gastroparesis after the operation who caused the undesirable symptoms of nausea, vomiting, abdominal pain, bloating and early satiety. The upper gastroin- testinal radiography showed a decrease in gastricmotility, and no stomal obstruction. The rest had curative effects through the reduction of gastric pressure, maintenance of water- electrolyte balance and nutritional status,a nd appli- cation of prokinetic drugs. There were no deaths in this group.Conclusion：The diagnosis of gastroparesis mainly de- pends on the clinical appearances, chest CT and digestive tract radiography. When the gastroparesis is confirmed, the oatient should be cured bv conservative means, especially by the application of enteral nutrition, prokinetic agents.