CAJ | 학술논문

目的探讨胃大部切除术后功能性排空障碍的临床特点及可能的发病机制.方法计算机检索中文生物医学数据库(CBMdisc)、万方数据库、维普数据库及中国知网数据库.检索年限均从建库到2008年12月,手工检索纳入文献及其参考文献、会议论文集、学位论文汇编等.按Cochrane系统评价方法筛选试验、评价纳入研究的方法学质量、提取资料,进行Meta分析.结果 17篇文献符合纳入标准,包括238例患者.研究结果:①功能性排空障碍患者的男女比例约为2:1,平均年龄约为53岁;②238例患者中接受毕I式手术者46例,接受毕Ⅱ式手术者(包括Roux-Y吻合术)192例,比例约为1:4,功能性排空障碍发生率为3.2%～7.0%;③功能性排空障碍的临床表现主要包括上腹部饱胀不适、恶心呕吐、顽固性呃逆及胃肠减压或呕吐后症状缓解等:④功能性排空障碍的治愈率约为98%.结论胃大部切除术后功能性排空障碍是胃大部切除术后的主要近期并发症之一,临床诊断应结合患者的临床症状及发病特点,其治疗手段首选保守治疗.
목적 탐토위대부절제술후공능성배공장애적림상특점급가능적발병궤제.방법 계산궤검색중문생물의학수거고(CBMdisc)、만방수거고、유보수거고급중국지망수거고.검색년한균종건고도2008년12월,수공검색납입문헌급기삼고문헌、회의논문집、학위논문회편등.안Cochrane계통평개방법사선시험、평개납입연구적방법학질량、제취자료,진행Meta분석.결과 17편문헌부합납입표준,포괄238례환자.연구결과:①공능성배공장애환자적남녀비례약위2:1,평균년령약위53세;②238례환자중접수필I식수술자46례,접수필Ⅱ식수술자(포괄Roux-Y문합술)192례,비례약위1:4,공능성배공장애발생솔위3.2%～7.0%;③공능성배공장애적림상표현주요포괄상복부포창불괄、악심구토、완고성애역급위장감압혹구토후증상완해등:④공능성배공장애적치유솔약위98%.결론 위대부절제술후공능성배공장애시위대부절제술후적주요근기병발증지일,림상진단응결합환자적림상증상급발병특점,기치료수단수선보수치료.
Objective To investigate the clinical features and pathogenesis of functional delayed gastric emptying after gastrectomy (FDGE). Method Based on the principles and methods of Cochrane systematic reviews, we searched CBMdisc, VIP, Wanfang and CNKI databases, from inception to Dec. 2008, and we also hand-searched relevant journals and conference proceedings. We evaluated the risk of the bias of the included RCTs according to the Cochrane Handbook for Systematic Reviews. Results 17 trials (a total of 238 participants) were included. Main results; ①The proportion of male and female of FDGE was about 2:1, the average age about 53-year-old; ②46 patients with Billroth-I surgery and 192 patients with Billroth-II surgery (including the Roux-Y anastomosis) in 238 participants, the ratio was about 1:4, and the incidence was 3.2%～7.0%; ③ The main clinical features of FDGE included: abdominal fullness, discomfort, nausea and vomiting, etc; ④The cure rate of FDGE was about 98%. Conclusions FDGE is one of the main complications after subtotal gastrectomy. Clinical diagnosis of FDGE should be combined with clinical symptoms and signs. The main treatment means of FDGE is conservative treatment.