胃癌术后残胃无力症46例病因与治疗分析

目的探讨胃癌术后残胃无力症的病因与治疗。方法对近10年1469例胃癌行胃大部切除术后发生残胃无力症46例病人进行病因和治疗结果回顾性分析。结果残胃无力症的病因是综合因素引起,病人对手术的恐惧和精神紧张可能是最主要的诱因。胃癌行大部切除术后发生持续性呕吐,呕吐量>800ml/d。经消化道造影和胃镜检查诊断为残胃无力症,行保守治疗,包括胃肠减压、胃肠内和外营养支持、各种促进胃肠蠕动药物和对症处理,平均治疗14.6天全部治愈。结论胃癌行胃大部切除术后发生残胃无力症是多因素引起,其中精神因素可能为最主要因素。经过检查一旦诊断为功能性残胃无力症,治疗原则为消除患者紧张性情绪,保守治疗,应避免再次手术。

Etiologic factors and therapeutic result of 46 cases of gastric atony after subtotal gastrictomy of gastric cancer

Objective To explore the etiologic factors and clinical treatment of the gastric atony after subtotal gastrectomy of gastric cancer.Methods Study the cause of disease and the clinical treatment of 46 patients with gastric atony after subtotal gastrectomy,1469 patients with gastric cancer who underwent subtotal gastrectomy from January 1996 to December 2005 were studied retrospectively.Results The cause of gastric atony after gastrectomy of gastric cancer was compound factors.The patients out of fear operation and psychic factor may be the main inducement,gastric atony after subtotal gastrectomy was diagnosed by symptoms(vomitive volume over 800 ml daily),X-ray and endoscopy.Conservatire treatment were suggested by continuous gastric intestinal decompression,nutrition support(enteral and exteral nutrition).Appropriate prokinetic agents may be benefited to patients.All the cases healed after treated for ten to forty-eighth days(mean 14.6 days).Conclusions Gastric stony after gastrectomy result from the comprehensive factors.The psychic factor may be the main factor.Principle of treatment of gastric atony after gastrectomy was conservative treatment including eliminating the patient's nervous stress.The operative treatment should be avoided.