胃手术后功能性胃排空障碍的诊断与处理

目的探讨胃手术后功能性胃排空障碍(FDGE)的临床特点和处理方法。方法对1998—2003年224例胃手术的病例资料进行回顾性分析。结果224例患者中有9例(4％)在术后3—10(平均7．2)d时出现FDGE，诊断根据临床表现、胃造影和胃镜检查确定。其中毕Ⅱ式胃肠吻合术患者FDGE的发病率为6．1％，显著高于毕Ⅰ式1．8％。经非手术综合治疗9—56(平均22)d后，8例治愈，1例因并发严重肺部感染死亡死亡。结论FDGE是胃术后的近期并发症，毕Ⅱ式吻合术后易发。通过上消化道造影及胃镜检查一般能明确诊断，确诊后采用非手术综合治疗多可治愈。

Diagnosis and treatment of functional delayed gastric emptying after gastrectomy

OBJECTIVE: To explore the clinical characteristics and treatment of functional delayed gastric emptying(FDGE) after gastrectomy. METHODS: From 1998 to 2003, clinical data of 224 patients undergone gastrectomy were analyzed retrospectively. RESULTS: Nine of 224 patients (4%) had FDGE from three days to ten days (average 7.2 days) after operation. Diagnosis was confirmed by clinical features,gastric contrast examination and gastroscope. The incidence of FDGE was 6.1% in the patients treated with Billroth II gastroenterostomy, which was higher than that with Billroth I gastroenterostomy (1.8%). Eight patients were cured by palliative treatment with recovery time from 9 to 56 days (average 22 days), but one patient died of severe pulmonary infection. CONCLUSIONS: FDGE is a common and early complication after gastrectomy, PDGE is more likely to occur in patients with Billroth II gastroenterostomy. Diagnosis can be confirmed by barium meal examination of gastrointestinal tract and gastroscopy. PDGE can be mostly cured by palliative treatment.