腹部手术后胃瘫的原因及诊治(附16例报告)

目的：探讨腹部手术后发生胃瘫的原因及其治疗和预防措施。方法：回顾性分析我院近年来腹部手术后发生胃瘫的16例患者的临床资料。结果：本组中，D2以上的胃癌根治术、扩大的胰十二指肠切除术、复杂的胆道手术、70岁以上的老年人、手术时间4h以上、术后应用自控镇痛的病人发病率较高；临床表现、胃肠钡餐造影及胃镜检查是诊断本病的主要手段；全部病人均经保守治疗6周内恢复正常。结论：要重视腹部大手术后胃瘫的发生，高龄、手术时间长、术后应用自控镇痛可能是胃癌、胰头癌及多次胆道手术后胃瘫发生的高危因素；综合保守治疗是治疗胃瘫的有效方法，应尽量避免再次手术。

Gastroparesis After Abdominal Operation: a Clinical Analysis of 16 Cases

Objective: To study the pathogenesis and treatment and preventive measure of gastroparesis after abdominal oper-ation. Methods: The clinical data from 16 cases of gastroparesis after abdominal operation were review retrospectively. Results: The high morbility of gastroparesis were found in the cases whose age were over 70 or operation time were over 4 hours, or who used patient - controlled analgesia or underwent gastric carcinoma radical operation or extensive duodenopancreatectomy or complex biliary operation. The clinical manifestation, barium meal examination and gastroscopy were the main diagnostic methods. All the patients recovered by undergoing conservative treatment within 6 weeks.Conclusion: We should take into ac-count the occurrence of gastroparesis after the major abdominal operation. Senility and long time of operation and patient - controlled analgesia after operation maybe the high risk factors of gastroparesis after operation of gastric carcinoma, caput pancre-atic carcinoma and multiple biliary operation. Combined conservative treatment is the effective treatment methods of gastroparesis and multiple operation should be avoided as low as possible.