常见的胃十二指肠疾病(双语教学).ppt

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * 新辅助化疗及辅助化疗方案选择 FOLFOX7方案（首选）： 5%GS 250ml ivgtt d1 2h 奥沙利铂130mg/m2 5%GS 250ml ivgtt d1 2h 甲酰四氢叶酸 400mg/m2 5-FU 2400mg/m2 共计240ml 5ml/h 持续泵入 48h 生理盐水 Radiotherapy Immunotherapy The Traditional Chinese Medicine Gene Therapy * * * * * * * * * * * * * * * * * * * * * * * * * * * * * POSTOPERATIVE COMPLICATIONS （1）postoperative gastric hemorrhage 24h ---- uncertain hemostasis in operation 4-6，anastomotic stoma bleeding postoperative complications （2） duodenal stump rupture Often in 1-2 days after operation。 48 resuture duodenal stump and make duodenal drainage. 48 abdominal cavity drainage。 postoperative complications of subtotal gastrectomy （3） gastrointestinal anastomotic stoma rupture or fistula rare 5-7 after operation postoperative complications of subtotal gastrectomy （4） postoperative obstruction ?AFFERENT LOOP SYNDROME or afferent loop obstruction输入段梗阻 ? anastomotic stoma obstruction Gastroparesis or Delayed Gastric Emptying(DGE) ? EFFERENT LOOP OBSTRUCTION postoperative complications of subtotal gastrectomy Early Dumping Syndrome： occurs within 20 to 30 minutes following ingestion of a meal and is accompanied by both gastrointestinal and cardiovascular symptoms it is more common after partial gastrectomy with the Billroth II reconstruction Late Dumping Syndrome: appears 2 to 3 hours after a meal、 Hypoglycemia syndrom postoperative complications of subtotal gastrectomy Alkaline Reflux Gastritis severe epigastric abdominal pain accompanied by bilious vomiting and weight loss usually not relieved by food or antacids patients with intractable symptoms -----Roux-en-Y anastomosis postoperative complications of vagotomy Esophagus perforation Lesser gastric curvature necrosis Dysphagia吞咽困难 Delaye