远端胃切除术后胃瘫发生的胃电图研究

Clinical research about the change of electrogastrogram in patients with gastroparesis after distal gastrectomy

目的:探讨胃电图在远端胃切除术后预测胃瘫发生中的临床意义。方法:47例远端胃切除患者根据术后是否发生胃瘫分为胃瘫组及对照组。比较两组术前及术后72 h、96 h、120 h体表胃电图的差异。同时对47例患者进行上腹部临床症状分度评分和生化指标检测。结果:与对照组相比,胃瘫组术后各阶段正常胃电慢波百分比均有升高趋势,手术前后各阶段胃电振幅均值均有不同程度减小;胃瘫组在术后72 h的恶心、呕吐和反酸评分均较对照组显著升高(P<0.01);胃瘫组术前血红蛋白和总胆红素含量均显著低于对照组(P<0.01和P<0.05),术后的白细胞计数显著高于对照组(P<0.01)。结论:胃电图参数结合上腹部临床症状分度评分和生化指标对腹部术后发生胃瘫可能性有一定参考。

Objective： To discuss the clinical value of electrogastrogram（EGG） in predictingpost-operative gastroparesis through EGG, clinical symptom score for Upper abdominal and Biochemical indexes in patients with gastroparesis after distal gastrectomy. Methods： 47 patients who underwent distal gastrectomy were divided in two groups based on the occurrence of gastroparesis.EGG was tested at pre-operation and 72 h,96 h,120 h post-operation. The clinical symptom score for Upper abdominal and Biochemical indexes were recorded before and after operation. Results：Compared with the control group, the EGG N% of gastroparesis group showed increasing trend after operation, the EGG amplitude mean of gastroparesis group showed decreasing trend duiring pre and post-operation; the nausea, vomiting and regurgitation scores of gastroparesis group at 72 h post-operation were significantly increased compared with the control group（P 〈0.01）; the hemoglobin and total bilirubin of gastroparesis group were significantly lower than control group at preoperation（P 〈0.01 and P 〈0.05）, and the white blood cell count was significantly higher than control group after operation（P 〈0.01）. Conclusions： EGG parameters combined with the upper abdominal clinical symptom score and biochemical indicators have a certain reference to the occurrence of gastroparesis after abdominal surgery.