28例上腹部手术后胃排空障碍临床体会

目的探讨上腹部手术后胃排空障碍的临床原因和治疗方法。方法对2002年12月至2008年12月本院768例上腹部手术后28例诊治为胃排空障碍的临床资料进行回顾性分析。结果胃排空障碍均发生于上腹部手术后5—12d。28例中胃相关手术患者占85．7％（24／28），其次术前流出道梗阻占75％（21／28）。中重度营养不良的发病率亦较高50％（14／28）。术后肠内营养患者发生率较低3．57％（1／28）。27例非手术综合治疗于术后10～58d恢复胃动力，平均（19±1．4）d痊愈出院，1例放弃治疗自动出院。结论预防胃排空障碍应有意识进行早期肠内营养，采取综合非手术疗法可治愈胃排空障碍，应尽量避免再次手术。

The clinical comprehension about the disorder of gastric emptying after operation on upper abdominal region

Objective To approach the clinical reasons and the therapy methods about the disorder of gastric emptying after operation on upper abdominal region.Methods The author analyzed retrospectively the clinical data of 28 cases that were diagnosed as the disorder of gastric emptying.these 28 cases occur in 768 operations on upper abdominal region from 2002 Dec to 2008 Dec.Results The disorder of gastric emptying cases happened in 5-12 days after operations on upper abdominal.85.7% (24/28)patients undertook the operations about stomach,75% (21/28)patients had outflow obstruction before operations.50% had middle-severe malnutrition.The incidence rate of the patients who had enteral nutrition are 3.57% (1/28).27 cases had the non-operation combined therapy and recovered in 10-58 days after the operations.The average time was (19 ± 1.4) days,and there was 1 case gave up the therapy.Conclusion To preven the disorder of gastric emptying should try to carry out the early enteral nutrition.The nonoperativ therapy can cure the disorder of gastric emptying,and one more operation should be avoided as far as possible.