腹部手术后胃瘫综合征诊治分析

目的探讨腹部手术后胃瘫综合征的诊断与治疗。方法回顾性分析1995年1月～2006年6月25例腹部手术后发生胃瘫综合征患者的临床资料。结果全组行胃手术16例，非胃手术9例（门奇静脉断流术4例，胰十二指肠切除术1例，小肠部分切除加粘连松解术1例，结肠癌根治术2例，胆总管探察加切开取石术1例）；临床表现为术后进食或夹闭胃管后出现腹胀、恶心，呕吐胆汁样胃液或胃管日引流量不减少，并经胃肠造影、胃镜等检查证实为功能性胃排空障碍；经禁食、胃肠减压、加强肠内外营养、促胃肠动力等保守治疗后全组患者得到治愈。结论胃瘫综合征是腹部手术后常见并发症，胃肠造影、胃镜检查是主要诊断手段，采用保守治疗为主的综合治疗能取得较好的效果。

Diagnosis and Treatment of Gastroparasis Syndrome After Abdominal Operation

Objective To explore the diagnosis and treatment of gastroparasis syndrome after abdominal operation. Methods Clinical data of 25 cases with gastroparasis syndrome after abdominal operation from Jan 1995 to June 2006 were analysed retrospectively. Results Gastrectomy and nongastrectomy amounted to 16 and 9 cases( portal-azygous vein disconnection in 4 cases, panceaticoduodenectomy in 1 case, partial small intestinectomy and adhesions lysis in 1 case, radical excision of colon carcinoma in 2 cases, choledocholithotomy in 1 case). Gastroparasis syndrome characterized by upper abdominal distension, nausea, vomiting after clipping the pipe or large quantity of gastric drainage after operations. Gastrointestinal series and gastroscopy confirmed functional delayed gastric emptying. All cases recoverd through non-operative therapy including fasting, continuous gastrointestinal decompression, total parenteral nutrition or enteral nutrition, adn administration of gastro-intestinal dynamic medicine. Conclusions Gastroparasis syndrome is the common complication after abdomianl operation, gastrointestinal series, gastroscopy are main diagnostic methods, conservative medication obtains good effect.