胃癌根治术后胃瘫综合征的临床分析

目的探讨胃癌根治术后胃瘫综合征（PGS）发生的病因、诊断和治疗方法。方法以2003年1月至2007年4月间我院收治的500例胃癌根治术患者为研究对象，回顾性分析12例并发PGS患者的临床资料，分析其临床表现、诊治过程和高危因素。结果焦虑或抑郁、术前有胃流出道梗阻患者更易发生PGS（P〈0．01）；毕Ⅱ式胃肠吻合较毕Ⅰ式更易发生PGS（P〈0．05）；经非手术治疗，PGS患者均可康复，平均治愈时间（28．64±15．74）d，其中肠内和肠外营养患者平均治愈时间较全肠外营养患者明显缩短（P〈0．05）。结论术后PGS是由多个因素导致的；X线上消化道造影和胃镜检查是主要的诊断方法，营养支持和胃肠动力药物等非手术治疗有效，应尽量避免再次手术。

Clinical analysis of postsurgical gastroparesis syndrome after radical gastrectomy for gastric cancer

Objective To analyze the etiology,diagnosis and treatment of postsurgical gastroparesis syndrome（PGS） after radical gastrectomy for gastric cancer. Methods Clinical datum of 500 cases with radical gastrectomy for gastric cancer were collected from January 2003 to April 2007, 12 cases with PGS were enrolled. The clinic manifestation, process of diagnosis, treatment and high risk factors for PGS were analyzed. Results Patients with anxiety and preoperative gastric outlet obstruction were easily complicated PGS（P〈0.01）. The risk of PGS with Billroth Ⅱ gastrojejunostomy were much higher than Billroth Ⅰ. The patients with PGS were usually recovered by non-operative treatments, and average recovery time was （28.64 ± 15.74）d. EN＋PN could more obviously shorten the recovery time than TPN（P〈0.05）. Conclusions PGS is induced by multiple factors. Radiography of the upper gastrointestinal tract and gastroscopy are main diagnostic modalities for PGS. Non-operative trea tments are effective for PGS, and reoperation should be avoided in patients with PGS.