腹部术后胃瘫的诊断和治疗

目的 探讨腹部术后胃瘫的可能危险因素、诊断及治疗方法。方法 对22例腹部术后胃瘫患者的潜在危险因素、临床表现、诊断方法、治疗手段进行回顾性分析。结果 本组中，术前长期流出道梗阻、恶性肿瘤、胰十二指肠切除术后、无胃切除的胃空肠吻合术及O型血的病 发病率较高，胃镜、上消化道造影及核素胃排空试验是诊断本病有价值的方法，经保守治疗后胃肠动力一般可在术后5周内恢复正常。结论 采用促动力药物在内的保守支持治疗是治疗腹部术后胃瘫的有效手段，应避免再手术。

Diagnosis and treatment of gastroparesis after abdominal surgery

Objective To investigate the possible contributing risk factors, diagnosis and treatment of gastroparesis after abdominal surgery. Methods Potential risk factors, clinical manifestations and therapeutic approaches of 22 cases of gastroparesis after abdominal operation were analyzed retrospectively. Results In this series, gastroparesis more frequently occured in those patients having a long-term preoperative gastric outlet obstruction, malignant tumor, O type blood group pancreaticoduodenectomy or simple gastrojejunostomy without gastric resection. Endoscopy, upper gastrointestinal radiography and radioisotope scintigraphy were effective methods in the diagnosis of gastroparesis, and normal gastrointestinal movement was achieved mostly in 5 weeks postoperatively by conservative treatments.Conclusions Postoperative gastroparesis can recover spontaneously after a longer period of supportive treatment combined with prokinetic drugs, and reoperation should be avoided.