腹腔非胃手术后胃瘫综合征76例

Gastroparesis syndrome after nongastrectomy abdominal operation: Report of 76 cases

目的：探讨腹腔非胃手术后胃瘫综合征（GSNG）的病因、诊断及治疗。方法：回顾性分析1992～2012年76例GSNG患者的临床资料。结果：76例患者在腹腔非胃手术后4～7d进食后出现上腹膨胀、恶心呕吐，吐物含有胆汁性胃液及食物。查体：上腹部膨满，无腹部压痛，振水音明显和肠鸣音减弱。胃肠减压管每天可吸出1000～3000mL胆汁样胃液。胃造影（稀钡或60％泛影葡胺）76例均显示胃无蠕动，呈松弛、静止状态，观察5～6h造影剂仍滞留胃内。持续胃肠减压、营养支持和维持水电解质、酸碱平衡，采用促进胃肠动力药物等非手术治疗，100％的患者于胃瘫发生后5-25（平均16．3）d恢复胃动力。结论：腹腔非胃手术后GSNG是多种因素所致胃功能改变，经非手术可以治愈。

Objective： To investigate the cause, diagnosis and treatment of gastroparesis syn- drome after nongastrectomy abdominal operation. Methodst The clinical data of 76 cases with gas- troparesis syndrome after nongastrectomy abdominal operation from 1992 to 2012 were retrospec- tively analyzed. Results： Gastropaaresis syndrome after nongastrectomy abdominal operation often occurred during 4-7 days postoperatively when the patients began to take in food, characterized by upper abdominal distension, nausea, vomiting, strong splashing bowel sound, weak bowel sound and large quantity of gastric drainage range from 1000 to 3000 mL every day. Barium meal was valuable not only in the diagnosis but also effective for promoting gas motility, tt revealed a non-peristinal, flabby and static stomach,and retention of contrast medium in the stomach even 5-6 hous later. All the patients recovered through non-operative therapy for 5-25 days including continous gastropare- sis decompression, TPN and gastro-intestinal dynamic medicine. Conclusion： The causes of gastroparesis syndrome after nongastrectomy abdominal operation are multifactorial, most of such pa- tients can be cured by non-operative therapy, no deaths.