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1、1On the diagnosis and treatment of gastroparesis after abdominal surgery (report of 10 cases)Keywords: abdominal surgery, gastroparesis, diagnosis, treatment Gastroparesis the emptying of the stomach functional as the main signs of gastric motility disorder syndrome, common in the gastrointestinal a
2、nd abdominal surgery. Its incidence in recent years there is an upward trend due to gastroparesis occurred, usually the duration of patients after surgery for a long time to resume normal diet, at the urging of family members or patients, some surgeons in the case of a clear understanding of this di
3、sease for patients blind to the implementation of unnecessary surgery. therefore to strengthen the disease understanding, in terms of the surgeon is very important. Surgery of our hospital from 1988 to 2004, by rule abdominal surgery after gastric paralysis were 10 cases are summarized as follows. 1
4、 clinical data 1.1 General information on this group of patients (n = 10), all male, age 58 to 81 years, 2mean age 72 years, 80 years old and not more than four cases, four cases of stomach surgery, 1 case of abdominal mucus adenoma with gastric mucinous adenocarcinoma, line laparotomy myxoma wide r
5、esection, small bowel resection, partial gastrectomy gastrojejunostomy, one cases of gastric cancer the radical RouxY anastomosis, and one cases of colon cancer three years after extensive abdominal metastasis, complete obstruction , rows wide range of intestinal adhesion release, part of the small
6、bowel resection, gastrojejunostomy, back to the anastomosis. one cases of patients with ascending colon l colon fistula, duodenal obstruction due to tumor than fixed, and 80-year-old patients, only the line cecum transverse colon and gastrojejunostomy. nothing to do with stomach surgery in six cases
7、, are colorectal radical mastectomy, radical resection of sigmoid colon cancer two cases of the Blind colorectal cancer of right colon cancer one cases of radical mastectomy, Dixon performed in 2 cases, 1 cases, the Miles surgery. patients before surgery, 8 patients had complete or incomplete intest
8、inal obstruction. 31.2 in patients with clinical manifestations generally after 3 7 d after onset of abdominal distension, and some only mild abdominal distension, 6 cases or significant abdominal distension, all or no abdominal tenderness, bowel sounds Disaccommodation. Six cases patients for 3 day
9、s within gastric juice 400 ml, 3 patients had removal of the tube into the liquid soft food, bloating, vomiting and again under the tube, all patients have reached the diagnostic criteria, juice volume of 800 ml / d, continuous more than 10 d, six cases of conservative treatment of gastric function
10、in more than three weeks before recovery of up to 1 cases to 32 days after surgery, all patients were conservative cure. 1.3 diagnostic criteria on the diagnostic criteria for gastric paralysis is not yet uniform, refer to the reports in the literature in recent years, more recognized standards: 1 o
11、ne or more of the tests suggest no gastric outflow tract mechanical obstruction, (2) gastric fluid drainage = 800 ml / d, duration of more than 10 days, (3) no water, electrolyte imbalance, The no stomach paralysis caused by underlying diseases such as 4diabetes, connective tissue disease, is not ap
12、plied to drugs that affect smooth muscle contraction. when patients multi-year history of diabetes, more likely to have gastroparesis. 1.4 auxiliary examination in eight cases of gastric angiography (meglumine diatrizoate diluent) shows contrast agent retention in the stomach, anastomosis without co
13、ntrast agent through the dynamic observation of gastric motility disappeared .4 h was observed after only a small amount of contrast agent reaches the small intestine the gastroscopy six cases, from the stomach to suck out a lot of stagnation slip solution, about 400 800 ml of gastric mucosal edema,
14、 two cases of gastrojejunostomy anastomosis, anastomotic edema, serious, but the endoscope through smoothly. 1.5 treatment of all patients with conservative treatment to be successful, recovery of gastrointestinal function in patients 16 to 32 days, an average of 24 days of conservative treatment in
15、clude the following aspects: (1) Psychotherapy: the postoperative stomach paralysis 5patients, due to the longer course, the psychological treatment of patients and their families is particularly important because patients with anxiety will directly affect the outcome of the disease, so the medical
16、staff to be patient for patients to explain, encourage, so that patients with confidence, with the treatment. therapy in this group of patients received good results. (2) nutrition support therapy: with disease status in patients before, poor nutritional status, and more with the low protein or anemia in this group, eight cases of patients with gastroparesis, serum white protein 30 g / L or less, seven cases of hemoglobin below 100 g / L in the treatment of at
