食管胃吻合术后胃排空障碍探讨.PDFVIP

消化外科 　2004 年第 3 卷第 1 期 43 - 45 Journal of Digestive Surgery ,2004 ,3 ( 1) :43 - 45 ·43 · ( ) 文章编号 : 1671 - 4555 2004 01 - 0043 - 03 ·临床研究· 食管胃吻合术后胃排空障碍探讨 赵云平 　王如文 　蒋耀光 　马铮 　龚太乾 　　【摘要】　目的 　探讨食管胃吻合术后胃排空障碍的原因、合理的预防措施及其有效的治疗方法。 方法 　回顾性分析我科 1982 年 1 月～2002 年 4 月间 32 例食管胃吻合术后胃排空障碍病人的临床资 料。结果 　32 例胃排空障碍病人 ,食管胃颈部吻合 24 例 ,胸腔内吻合 8 例。占同期食管癌手术 1 378 例的 2. 3 % 。25 例功能性胃排空障碍病人中 22 例经保守治愈 ,1 例死亡 ,死亡率为 4. 0 % ;7 例机械性 胃排空障碍病人经手术治愈。结论 　胃排空障碍多见于高位食管胃吻合术后, 以食管胃颈部吻合者 多见 ,其发生与手术操作和术后处理不当有关 , 胃排空障碍多为功能性,少数为机械性。前者大多可 经保守治疗而痊愈 ,后者则必须手术解除梗阻。本文还对食管癌术后胃排空障碍的定义、诊断与鉴别 诊断进行了探讨。 　　【关键词】　食管癌 　　外科治疗 　　食管胃吻合 　　胃排空障碍 　　【中图法分类号】　R656. 6 　　R735. 2 　　　　【文献标识码】　A Delayed gastric emptying after high position esophagogastrostomy in patients with esophageal carcinoma　 Zhao Yunping , Wang Ruwen , Jiang Yaoguang , Ma Zheng , Gong Taiqian. Department of Thoracic Surgery , Institute of Surgery Research , Daping Hospital , Third Military Medical University , Chongqing 400042 　　【Abstract 】　Objective 　To evaluate the incidence of delayed gastric emptying after esophagectomy and in vestigate methods to treat and prevent it. Methods 　From January 1982 to April 2002 , data of 32 patients with de layed gastric emptying after esophagectomy were studied retrospectively. Results 　The incidence of delayed gastric emptying after esophagectomy in 2 427 patients with esophageal cancer was 2. 3 %. There were 25 functional and 7 mechanical disorders. 25 patients with functional gastric emptying disorder recovered after nonsurgical treatment. All the mechanically obstructive cases were treated surgically. Of the 32 patients with delayed gastric emptying , 24 ( had esophagectomy with cervical anastomosis , 7 had intrathoracic anastomosis. The mortality rate