胃大部切除术后功能性排空障碍的诊治

目的探讨胃大部切除术后残胃功能性排空障碍的病因、发生机制、诊断和治疗方法。方法对1994~2005年间452例行胃大部切除术病人的临床资料进行回顾性分析。结果452例中有24例出现胃功能性排空障碍,发生率为5.3%,均发生于术后3~12 d。23例(95.7%)经非手术治疗于术后10~28 d胃排空功能恢复,痊愈出院;1例(4.3%)因呼吸衰竭死亡。结论胃大部切除术后功能性排空障碍的病因是多方面的。消化道造影和胃镜检查是诊断本病的重要方法,也是鉴别机械性梗阻的重要手段。采取非手术治疗均可治愈,辅助治疗有较好的疗效。

DIAGNOSIS AND TREATMENT OF FUNCTIONALLY DELAYED GASTRIC EMPTYING AFTER SUBTOTAL GASTRECTOMY

ObjectiveTo explore the etiology,mechanism,diagnosis and treatment of functionally delayed gastric emptying after subtotal gastrectomy.MethodsClinical data of the subtotal gastrectomy(n=452) performed in 1994 to 2005 were analyzed retrospectively.ResultsThe delayed gastric emptying occurred in 24 of 452 patients(5.3%) within three to 12 days after the operation.Most of them(23/24,95.7%) regained the emptying function 10 to 28 days postoperatively with nonoperative therapy.One(4.3%) died of respiratory failure.ConclusionThe cause of functionally delayed gastric emptying after subtotal gastrectomy is multiple.Upper gastrointestinal radiography and gastroscopy are important for the diagnosis.This problem can be solved with nonoperative therapy.