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目的 :探讨胃癌根治术后功能性胃排空障碍 (FSED)的临床特点及治疗。方法 :回顾分析 2 3例胃癌根治术后FSED的临床资料。结果 :术前合并幽门梗阻的患者 ,FSED发生率高达 17.1% (13/76 ) ,显著高于术前未合并幽门梗阻患者 2 .2 % (10 /4 5 7) (P <0 .0 5 )。行毕Ⅱ式胃肠吻合术患者FSED的发生率 5 .4% (17/312 )显著高于毕Ⅰ式 2 .7% (6 /2 2 1) (P <0 .0 5 )。 2 3例患者确诊FSED后 ,给予非手术综合治疗 8d～ 6 3d ,平均 2 3 .1d治愈出院。随访 2 2例 ,6个月无复发。结论 :FSED是胃癌根治术后早期常见并发症 ,术前合并幽门梗阻及行毕Ⅱ式吻合术为易发因素。通过上消化道造影及胃镜检查一般能明确诊断 ,确诊后采用非手术综合治疗多可治愈。
Objective: To investigate the clinical features and treatment of functional gastric emptying (FSED) after radical gastrectomy. Methods: The clinical data of FSED after radical gastrectomy in 23 patients were retrospectively analyzed. Results: The prevalence of FSED in patients with preoperative pyloric obstruction was as high as 17.1% (13/76), which was significantly higher than that in patients without preoperative pyloric obstruction (2. 2%, 10/47) (P < 0.05). ). The incidence of FSED in patients undergoing type II gastrointestinal anastomosis was 5.4% (17/312) significantly higher than that of type II (6.2% (6/221) (P < 0.05). After FSED was diagnosed in 23 patients, non-surgical comprehensive treatment was given for 8 days to 63 days, with an average of 23.1 days after being cured and discharged. Follow-up was performed in 22 patients without recurrence in 6 months. Conclusion: FSED is an early common complication after radical gastrectomy for gastric cancer. Preoperative pyloric obstruction combined with complete type II anastomosis are prone factors. Through the upper gastrointestinal angiography and gastroscopy can generally confirm the diagnosis, after the diagnosis using non-surgical comprehensive treatment can be cured.