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目的探讨食管癌、贲门癌切除术后胃排空障碍的发生原因、诊断和治疗措施。方法对2002年3月至2008年5月间实施的523例食管癌、贲门癌切除术患者的临床资料进行回顾性分析。结果本组病例发生胃排空障碍9例,发生率1.72%(9/523)。8例为功能性胃排空障碍,发生于术后7～10d,经保守治疗治愈。1例为机械性胃排空障碍,发生于术后第7天,二次手术解除梗阻后治愈。结论迷走神经离断和胃解剖位置的变化是本病的主要原因,X线造影和胃镜检查是诊断本病的主要方法。功能性胃排空障碍,一般行保守治疗,机械性胃排空障碍应早期手术。
Objective To investigate the causes, diagnosis and treatment of gastric emptying disorders after esophageal cancer and gastric cardia resection. Methods The clinical data of 523 patients undergoing esophagectomy and gastric cardia resection between March 2002 and May 2008 were analyzed retrospectively. Results There were 9 cases of gastric emptying disorder in this group, the incidence rate was 1.72% (9/523). 8 cases of functional gastric emptying disorder, occurred in 7 to 10 days after surgery, cured by conservative treatment. One case was a mechanical gastric emptying disorder, which occurred on the 7th day after operation. The second operation was cured after the obstruction was relieved. Conclusion Variations of vagus nerve and stomach anatomy are the main causes of this disease. X-ray and gastroscopy are the main methods to diagnose this disease. Functional gastric emptying disorders, the general line of conservative treatment, mechanical gastric emptying disorders should be early surgery.