中华腔镜外科杂志（电子版）
中華腔鏡外科雜誌（電子版）
중화강경외과잡지（전자판）
CHINESE JOURNAL OF LAPAROSCOPIC SURGERY ( ELECTRONIC EDITION)
2014年
3期
233-235
,共3页
孔凡东%何永忠%杜汉朋%聂向阳%龚独辉
孔凡東%何永忠%杜漢朋%聶嚮暘%龔獨輝
공범동%하영충%두한붕%섭향양%공독휘
腹腔镜%直肠癌%胃瘫%治疗
腹腔鏡%直腸癌%胃癱%治療
복강경%직장암%위탄%치료
Laparoscopic%Rectal cancer%Gastroparesis%Treatment
目的：探讨腹腔镜辅助直肠癌术后并发胃瘫的可能病因及综合治疗措施。方法回顾性分析我院近年来腹腔镜辅助直肠癌术后发生胃瘫的10例患者的临床资料及综合治疗效果。结果10例患者，男性3例，女性7例。在手术后4~5 d 肛门排气后进食流质饮食出现上腹饱胀、恶心呕吐，呕吐物含有胆汁样胃液。给予留置胃肠减压管，每天可吸出800 ml 以上胆汁样胃液。经胃管行胃造影显示胃无蠕动4例或蠕动明显减弱6例，观察5~6 h 造影剂仍滞留胃内。予以持续胃肠减压、静脉营养支持等治疗；并采用促进胃肠动力药物和中医针灸治疗等非手术治疗；全部患者于胃瘫发生后7~15（平均12.3）d 恢复胃动力。结论腹腔镜辅助下直肠癌术后并发胃瘫，是多种因素所致短暂性胃功能改变，可能与麻醉、患者精神因素等有关，经非手术的综合治疗措施可治愈。
目的：探討腹腔鏡輔助直腸癌術後併髮胃癱的可能病因及綜閤治療措施。方法迴顧性分析我院近年來腹腔鏡輔助直腸癌術後髮生胃癱的10例患者的臨床資料及綜閤治療效果。結果10例患者，男性3例，女性7例。在手術後4~5 d 肛門排氣後進食流質飲食齣現上腹飽脹、噁心嘔吐，嘔吐物含有膽汁樣胃液。給予留置胃腸減壓管，每天可吸齣800 ml 以上膽汁樣胃液。經胃管行胃造影顯示胃無蠕動4例或蠕動明顯減弱6例，觀察5~6 h 造影劑仍滯留胃內。予以持續胃腸減壓、靜脈營養支持等治療；併採用促進胃腸動力藥物和中醫針灸治療等非手術治療；全部患者于胃癱髮生後7~15（平均12.3）d 恢複胃動力。結論腹腔鏡輔助下直腸癌術後併髮胃癱，是多種因素所緻短暫性胃功能改變，可能與痳醉、患者精神因素等有關，經非手術的綜閤治療措施可治愈。
목적：탐토복강경보조직장암술후병발위탄적가능병인급종합치료조시。방법회고성분석아원근년래복강경보조직장암술후발생위탄적10례환자적림상자료급종합치료효과。결과10례환자，남성3례，녀성7례。재수술후4~5 d 항문배기후진식류질음식출현상복포창、악심구토，구토물함유담즙양위액。급여류치위장감압관，매천가흡출800 ml 이상담즙양위액。경위관행위조영현시위무연동4례혹연동명현감약6례，관찰5~6 h 조영제잉체류위내。여이지속위장감압、정맥영양지지등치료；병채용촉진위장동력약물화중의침구치료등비수술치료；전부환자우위탄발생후7~15（평균12.3）d 회복위동력。결론복강경보조하직장암술후병발위탄，시다충인소소치단잠성위공능개변，가능여마취、환자정신인소등유관，경비수술적종합치료조시가치유。
Objective To investigate the possible causes and comprehensive treatment measures of postoperative complication of gastroparesis after paroscopic -assisted rectal cancer. Methods A retrospective analysis on clinical data and comprehensive treatments of 10 patients of our hospital in recent years, which suffer from gastroparesis after the laparoscopic-assisted rectal cancer surgery. Results When eating liquid diet after surgery and 4~5 days anus exhaust, 10 patients (3 men and 7 females) appeared the phenomenon of epigastric fullness, nausea and vomiting with containing bile juice. Indwelling gastrointestinal decompression tube, it could be sucked out of more than 800ml bilious gastric juice every day. Gastric angiography(76% diatrizoate) showed four cases in which the stomach is without peristalsis, and six cases in which the stomach is significantly weakened, and after 5 ~6 h observation, contrast agents stranded in the stomach. With continuous decompression, and parenteral nutrient support therapy, as well as non-surgical treatments including gastrointestinal motility drugs and acupuncture treatment, all patients with gastroparesis restore gastric motility after 7 ~15 (average 12.3) days. Conclusions The occurrence of gastroparesis after laparoscopic-assisted rectal, was a transient change in gastric function, due to a variety of causes. It may be associated with the anesthesia and patients’ mental factors, and could be cured by non-surgical treatment.
