远端胃癌根治性手术术后胃瘫综合征30例临床分析

Clinical analysis of 30 cases with postsurgical gastroparesis syndrome after radical subtotal gastrectomy for distal gastric cancer

目的分析远端胃癌根治性胃大部切除术术后胃瘫综合征(PGS)的临床特点和诊疗结果。方法回顾性分析行开放根治性远端胃大部切除术胃癌患者562例的临床病理资料;其中,30例术后发生PGS。结果肿瘤浸润程度深、有淋巴结转移和肿瘤分期高患者的PGS发生率较高(P<0.05或P<0.01)。经胃肠减压、肠内营养、促进胃肠动力等保守治疗后,30例PGS患者均获得恢复。焦虑患者恢复时间较非焦虑患者长(P<0.05);经个体化心理疏导后,患者迅速恢复口服饮食。结论 PGS发生率与肿瘤浸润程度、淋巴结转移和临床分期有关。PGS患者易发生持续的焦虑情绪,个体化心理疏导能促进患者恢复。

Objective To analyze the clinical features,diagnosis and treatment of postoperative gastroparesis syndrome（PGS）after open radical subtotal gastrectomy for distal gastric cancer.Methods Clinicopathological data of 562 cases underwent open radical distal subtotal gastrectomy for distal gastric cancer were retrospectively analyzed,of whom PGS occurred in 30 cases.Results The incidence of PGS was higher in the patients with deep tumor invasion,lymph node metastasis and high stage of tumor（P〈0.05 or P〈0.01）.Gastric function was recovered in all patients through conventional therapy.The recovery time of patients with anxiety was longer than that of those without（P〈0.05）.After individualized mental intervention,the patients resumed oral diet quickly.Conclusion The incidence of PGS is associated with tumor invasion,lymph node metastasis and tumor stage.Comprehensive mental intervention is helpful to improve anxiety and shorten recovery time of PGS patients.