摘要
目的 治疗和预防食管贲门癌切除后胸胃排空障碍。方法 回顾性分析 384 0例食管贲门癌切除术后发生胸胃排空障碍 4 2例的病因和诊治情况。结果 功能性胸胃排空障碍 2 4例 ,机械性 18例 ,其中 ,重建食管膈裂孔过紧 2例 ,食管裂孔回缩狭窄 2例 ,胃上提过多幽门牵拉过紧成角 6例 ,胃在幽门处扭转 2例 ,幽门被纤维粘连索带压迫 6例。功能性胸胃排空障碍经保守治疗全部治愈 ,机械性胃排空障碍则全部行手术治疗而愈。结论 食管贲门癌切除术后胸胃排空障碍多与手术操作不当有关 ,术中正确细致的操作是预防这一并发症的关键。功能性胃排空障碍保守治疗可治愈 ,机械性胃排空障碍尽早确诊、及时手术 ,效果满意。
Objective To evaluate the incidence of delayed gastric emptying after opetation for patients with esophageal and cardiac carcinoma and investigate reasonable methods to cure and preveent it.Methods 3840 patients with esophageal and cardiac cancer underwent operation treatment including 42 patients with delayed gastric emptying after operation were retrospectively studied.Results The incidence of delayed gastric emptying after esophagectomy or upper-gastrectomy was 1.09%.There were 24 funtional and 18 mechanical disorders.The mechanically obstructive causes included stomach volvulated at the pylorus,pylorus constricted by fabric adhesion ribbon,esophagus hiatus stenosis due to contraction,pylorus angled as a result of thoractic stomach drawed tightly and teconstructed esophageal hiatus tightened up.24 patients with functional gastric emptying disorder recovered with non-surgical treatment.All the mechanical obstruction cases were successfully treated surgically.Conclusion In order to prevent the obstructive gastric emptying disorder,surgical technique should be considered carefully during operation.Because the obstructive cases require surgical intervention and the functional can recovere without surgical treatment,it is important to differentiate types of the disease.
出处
《中国基层医药》
CAS
2004年第9期1060-1061,共2页
Chinese Journal of Primary Medicine and Pharmacy
