保留幽门胰十二指肠切除术后胃排空障碍的预防和治疗(附6例报告)

摘要

目的探讨保留幽门胰十二指肠切除术(PPPD)后胃排空障碍(DGE)的预防和诊治方法。方法回顾性分析1992年2月～2000年6月PPPD后12例临床资料。结果 DGE发生率为50%，其中胃造口者2/2，无胃造口者4/10，经空肠造口肠内营养与细硅胶管胃减压，配合中西医结合治疗均获满意疗效，其中经鼻细硅胶管胃减压比胃造口胃减压胃蠕动功能恢复快7～15天。结论 PPPD后DGE的发生率高，宜常规行预防性空肠造口术。细硅胶管有良好的胃减压效果。尽可能减轻对胃的手术创伤可减少PPPD后DGE的发生，胃造口能增加胃的创伤并延长DGE的恢复时间。中西医结合治疗DGE有效。%Objective To evaluate the effects of preventing and treating delayed gastric emptying (DGE)in the patients with pylorus preserving pancreaticoduodenostomy(PPPD).Methods The clinical data about PPPD from 1992～2000 were analyzed retrospectively.Results The incidence rate of DGE was 50%,among which gastrostomy was performed in 2/2 cases and not performed in four tenths.Comparing gastric decompression through noses with gastrostomy,the function of gastric wriggle recovered ahead of seven to fifteen days in the former group.Conclusion The incidence rate of DGE in the patients with PPPD is very high.Preventive jejunostomy should routinely be taken and the application of the thin silicon rubber tube through nose is very effective to gastric decompression,combining the traditional Chinese medicine with western medicine.