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食管、贲门癌切除术后胸胃排空障碍的诊治体会

Diagnosis and treatment of delayed gastric emptying after resection of esophageal and gastric cardia carcinoma
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摘要 目的探讨食管、贲门癌切除术后胸胃排空障碍的病因、诊断和防治措施。方法回顾性分析1993年1月至2009年12月19例食管、贲门癌切除术后胸胃排空障碍患者的临床资料。结果3例确诊为机械性胸胃排空障碍,及时行开腹手术解除梗阻后痊愈出院。16例为功能性胸胃排空障碍,经保守治疗,于发病后7—19d胸胃功能恢复,进食顺利,痊愈出院。结论食管、贲门癌术后胸胃排空障碍根据临床表现、上消化道造影及胃镜检查即可确诊,其中大多数为功能性胸胃排空障碍,经保守治疗即能痊愈,少数为机械性胸胃排空障碍需及时手术处理。改善术前营养状况、严格手术操作规范、术后有效的胃肠减压及加强饮食管理是预防胸胃排空障碍发生的重要措施。 Objective To investigate the causes, diagnosis and methods of prevention and treatment of delayed gastric emptying (DGE) after resection of esophageal and gastric cardia carcinoma. Methods The datas of 19 patients who had DGE after resection of esophageal and gastric cardia carcinoma in hospital from January 1993 to December 2009 were retrospectively analyzed. Results Three cases were confirmed as mechanical DGE and these patients were removed obstruction and cured by operation in time. Sixteen cases were functional DGE and were cured by conservative treatment, gastric function recovered after 7-19 d. Conclusions According to clinical manifestation,upper gastrointestinal radiography and endoscopy, the diagnosis of DGE after resection of esophageal and gastric cardia carcinoma can be confirmed. The majority of DGE are functional and the patients could be cured by conservative treatment. But the patients who have mechanical obstruction have to operate in time. The best way to prevent DGE is to improve preoperative nutrition status, enforce standard surgical manipulation, maintain effective gastrointestinal decompression and strengthen postoperative dietary control.
出处 《中国医师进修杂志》 2010年第32期5-7,共3页 Chinese Journal of Postgraduates of Medicine
关键词 食管肿瘤 诊断 治疗 胃排空障碍 Esophageal neoplasms Diagnosis Therapy Delayed gastric emptying
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