CAJ | 학술논문

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.
목적 탐토식관、분문암절제술후흉위배공장애적병인、진단화방치조시.방법 회고성분석1993년1월지2009년12월19례식관、분문암절제술후흉위배공장애환자적림상자료.결과 3례학진위궤계성흉위배공장애,급시행개복수술해제경조후전유출원.16례위공능성흉위배공장애,경보수치료,우발병후7～19d흉위공능회복,진식순리,전유출원.결론 식관、분문암술후흉위배공장애근거림상표현、상소화도조영급위경검사즉가학진,기중대다수위공능성흉위배공장애,경보수치료즉능전유,소수위궤계성흉위배공장애수급시수술처리.개선술전영양상황、엄격수술조작규범、술후유효적위장감압급가강음식관리시예방흉위배공장애발생적중요조시.
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.