食管癌、贲门癌术后胸胃排空障碍的诊断和治疗

目的：探讨食管癌、贲门癌术后胸胃排空障碍的发生原因、诊断和治疗。方法：对1997年1月到2001年12月五年问施行1861例食管癌、贲门癌切除术的病人临床资料进行回顾性分析。结果：本组病例发生胸胃排空障碍27例，发生率1．45％，其中机械性胸胃排空障碍6例，功能性胸胃排空障碍21例，均发生于术后3天～12天，再次手术治疗8例；治愈26例，死亡1例。结论：鉴别胃排空障碍是由机械性还是功能性引起的尤为重要，上消化道造影、胃镜检查是鉴别两者的重要方法。对食管癌、贲门癌术后功能性胃排空障碍应采取保守治疗，而由机械性原因所致，一旦确诊应立即手术。

Diagnosis and Treatment of Delayed Intrathoracic Gastric Emptying after Esophageal or Cardial Cancer Resection

Objective: To investigate the possible cause of delayed emptying of postoperative intrathoracic stomach(DEPIS) and its diagnosis and treatment after esophageal or cardial cancer resection.Methods:The clinical data of 1861 patients who under went esophageal or cardial cancer resection from 1997 to 2001 were restropectively analyzed.Results:There were 27 cases with delayed emptying of introthoracic stomach(27/1861,1.45%).Among them,21 cases were functional delayed emptying,and others were mechanical delayed emptying.8 patients were reoperated.26 patients were cured and one patient was died of massive bleeding from the upper alimentary tract.Conclusion:It is important to differentiate functional DEPIS from mechanical DEPIS.Upper gastrointestinal radiography and endoscopy are the important methods for differential diagnosis.Conservative therapy should be used for the patients with functional DEPIS and reoperation should be done at once for relieving mechanical DEPIS.