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目的 治疗和预防食管贲门癌切除后胸胃排空障碍。方法 回顾性分析 384 0例食管贲门癌切除术后发生胸胃排空障碍 4 2例的病因和诊治情况。结果 功能性胸胃排空障碍 2 4例 ,机械性 18例 ,其中 ,重建食管膈裂孔过紧 2例 ,食管裂孔回缩狭窄 2例 ,胃上提过多幽门牵拉过紧成角 6例 ,胃在幽门处扭转 2例 ,幽门被纤维粘连索带压迫 6例。功能性胸胃排空障碍经保守治疗全部治愈 ,机械性胃排空障碍则全部行手术治疗而愈。结论 食管贲门癌切除术后胸胃排空障碍多与手术操作不当有关 ,术中正确细致的操作是预防这一并发症的关键。功能性胃排空障碍保守治疗可治愈 ,机械性胃排空障碍尽早确诊、及时手术 ,效果满意。
Objective To treat and prevent thoracic gastric emptying disorders after esophageal and cardiac resections. Methods Retrospective analysis of 384 cases of esophageal and cardiac resection of 42 patients with thoracic gastric emptying causes and diagnosis and treatment. Results Functional thoracic gastric emptying 24 cases, mechanical 18 cases, of which reconstruction of the esophageal diaphragm hole too tight in 2 cases, 2 cases of esophageal hiatus retraction stenosis, the stomach to mention too many pylorus tight tight corner formation in 6 cases , The stomach reversed in 2 cases of pylorus, pyloric adhesions in 6 cases of fibrous adhesions. Functional thoracic gastric emptying all cured by conservative treatment, mechanical gastric emptying all the more surgical treatment and more. Conclusion Thoracic gastric emptying after esophageal and cardiac resections is related to improper operation. The correct operation in operation is the key to prevent this complication. Conservative treatment of functional gastric emptying can be cured, early diagnosis of mechanical gastric emptying, timely surgery, the effect is satisfactory.