胃大部切除术后残胃功能性排空障碍的诊断和治疗

目的:探讨胃大部切除术后功能性胃排空障碍的发生机制、诊断和治疗方法.方法:对1994年至2005年收治的215例胃大部切除术患者的临床资料进行回顾性分析.结果:本组共发生功能性胃排空障碍13例,发生率6%,均发生于术后3～15天.所有患者均经保守治疗出院,均于31天内治愈.结论:术后残胃和远端空肠正常的运动功能破坏是发生功能性胃排空障碍的主要原因,上消化道造影及胃镜检查是诊断本病、鉴别机械性梗阻的重要方法.采取非手术治疗一般均可治愈,针对胃排空动力学机制的改变采用促胃肠动力药可能收到较好的疗效.

DIAGNOSIS AND TREATMENT OF FUNCTIONAL DELAYED GASTRIC EMPTYING AFTER SUBTOTAL GASTRETOMY

Objective:To investigate the possible causes of functional delyed gastric emptying(FDGE) and its diagnosis and treatment. Methods:Clinical data of 215 patients with subtotal gastrectomy from 1994 to 2005 were retrospectively analysed. Results:FDGE occurred in 13 of 215 patients(6%)3 to 15 days after surgery. All the 13 patients recovered after medical therapy and were discharged 100% within 31 days. Conclusion:Alteration of gastrointestinal motility may be the main cause of FDGE.Contrast examination of upper digestive tract and gastroscopy are the main means for diagnosis of PDGE and differential diagnosis uith mechanical ileus. Gastrointestinal motility can return spontaneously after a long period of medical therapy and there is no need for reoperation for gastric stasis. Some enterokinetic drugs may have benefical effect on postoperative gastrointestinal motility.