胰十二指肠切除术后胃瘫的诊断和治疗

Clinical diagnosis and treatment strategies for postoperative gastroparesis syndrome after pancreati- coduodenectomy

目的探讨胰十二指肠切除术后胃瘫综合征（PGS）的病因和临床诊治方法。方法分析2010年1月至2015年10月在北京大学人民医院肝胆外科行胰十二指肠切除术的178例患者中发生PGS的19例患者的临床资料。结果本组患者PGS发生于术后的7～14d。经过保守治疗恢复时间为10—72d，平均29．61d。术前低蛋白血症、术中出血量、手术时间和术后有无腹部并发症与PGS的发生相关。结论PGS是胰十二指肠切除术后的常见并发症。采用禁食、胃肠减压、加强营养支持改善胃肠动力等治疗措施，绝大多数患者可以痊愈。

Objective To investigate the causes, diagnosis and treatment strategies for postsurgi- cal gastroparesis syndrome （PGS） after pancreaticoduodenectomy. Methods The clinical data of 19 pa- tients with PGS after pancreaticoduodenectomy who were admitted to the Peking University People＇ s Hospi- tal from January 2010 to October 2015 were retrospectively analyzed. Results PGS of these 19 patients oc- curred within 7 - 14 days after operation. All of the PGS patients were cured with 10 to72 days （ mean 29. 61 days） by conservative therapy. Pre -operative hypoproteinemia, intraoperative blood loss, operative time, and postoperative comphcations were risk factors of PGS. Conclusion PGS is a common complica- tion after pancreaticoduodenectomy. Most patients can be cured by fasting, gastrointestinal decompression, nutritional support, gastrointestinal motility medicines and other conservative therapy.