食管贲门癌术后早期胸胃排空障碍的原因分析(附13例报告)

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食管贲门癌切除、胃或残胃代食管术是最常用的手术方式,由于胃的位置发生变化及手术的各种原因而导致术后早期胸胃排空障碍.据报告发生率一般为0.1%~1.3%我院自1983年以来共发生术后早期胸胃排空障碍患者13例,本文结合临床资料对胸胃排空障碍可能的原因进行探讨.1 临床资料13例患者中,男性11例,女性2例;年龄56~71岁,平均年龄58.6岁.食管癌8例,贲门癌5例;均在全麻下行左后外侧切口,食管癌经第六肋间或第六肋床进胸,贲门癌经第七肋间或第七肋床进胸.消化道重建采用食道胃主动脉弓后上吻合术者9例,弓前上吻合术者2例,食管残胃吻合术者5例.术后发生胸胃排空障碍时间:术后3天7例、5天4例、7天2例.症状与体征:术后3天停胃肠减压,经胃管滴入清流质后患者逐渐出现胸闷、气短、呼吸困难(食管癌者更为明显),多数患者伴有不同程度的呕吐,吐物多为咖啡色胃液,吐后症状缓解.术侧听诊 Esophageal and cardia cancer resection, gastric or residual gastrostomy esophagectomy are the most commonly used surgical methods, due to changes in the location of the stomach and various causes of surgery leading to early postoperative thoracic gastric emptying disorders. The reported incidence is generally 0.1% ~1.3% of our hospital have had 13 patients with early thoracic gastric emptying disorder since 1983. This article combined with clinical data to explore the possible causes of thoracic gastric emptying disorders. 1 Clinical data 13 patients, 11 males There were 2 females, aged 56-71 years old and mean age 58.6 years. There were 8 cases of esophageal carcinoma and 5 cases of cardiac cancer. All patients underwent left posterolateral incision under general anesthesia. Esophageal cancer entered the chest through the sixth intercostal space or the sixth intercostal space. Cardiac cancer enters the chest through the seventh intercostal space or the seventh ribbed bed. In the digestive tract reconstruction, 9 cases were treated with esophagogastric aortic arch anastomosis, 2 cases were performed anterior arch anastomosis, and 5 cases were treated with residual gastrostomy. Chest emptying time: 7 days after operation on 3 days, 4 cases on 5 days, and 2 cases on 7 days. Symptoms and signs: Gastrointestinal decompression was stopped on the 3rd day after the operation. The patient developed chest tightness gradually after the tube was instilled into the clear fluid. , shortness of breath, difficulty breathing (esophageal cancer is more obvious), most patients with varying degrees of vomiting, spit is mostly brown Solution, after vomiting symptoms. Operated side auscultation
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