贲门癌根治性全胃切除术后 Roux-en-Y 滞留综合征的研究

摘要

Objective To analyze the occurrence and prevention of Roux-en-Y stasis syndrome after cardiac carcinoma total gastrectomy .Methods The clinical data of 57 cases of total gastrectomy of cardiac cancer patients with Roux-en-Y stasis syndrome were retrospectively analyzed .Results In 57 patients,51 cases were followed up .There were 8 cases of obvious gastro-intestinal symptoms:2 cases of nausea ,vomiting only;3 cases of abdominal pain ,abdominal distension ,symptoms increased after eating;3 cases of abdominal pain ,abdominal distension accompanied by nausea ,vomiting.7 cases were confirmed as Roux-en-Y stasis syndrome,1 cases of tumor recurrence .Incidence rate of Roux-en-Y stasis syndrome was 13.7%(7/51).All the 7 patients were treated conservatively .Conclusion Roux-en-Y stasis syndrome was associated with Roux intestinal loop length and total gastrectomy.Early postoperative enteral nutrition and low dose of erythromycin can prevent its occurrence .%目的：分析贲门癌全胃切除术后Roux-en-Y滞留综合征发生的原因及其防治。方法回顾性分析57例贲门癌根治性全胃切除术后发生Roux-en-Y滞留综合征患者的临床资料。结果57例患者中51例获得随访，其中8例出现明显的胃肠道症状：2例出现单纯的恶心、呕吐；3例出现腹痛、腹胀，进食后症状加重；3例出现腹痛、腹胀同时伴恶心、呕吐。7例证实为Roux-en-Y滞留综合征，1例为肿瘤复发。术后Roux-en-Y滞留综合征发病率为13．7％（7/51），7例患者均行保守治疗。结论 Roux-en-Y滞留综合征的发生与Roux肠袢的长度及是否全胃切除有关，术后早期应用肠内营养剂及低剂量红霉素可预防其发生。