改良胃管置入空肠在预防胰十二指肠切除术后胃排空障碍的作用
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摘要
观察改良胃管置入空肠对预防胰十二指肠切除术后胃排空障碍的作用。回顾性分析赤峰市医院行胰十二指肠切除术后胃排空障碍的发生几率、胃管引流量、胃管留置时间、再次置入胃管的病例数、术后消化道造影情况及住院时间的差异。结果显示病例组中2例发生胃排空障碍,发生率为3.70%。对照组中11例发生胃排空延迟,发生率为27.50%(P<0.05)。病例组的平均住院时间为(14±2.5)d,对照组的平均住院时间为(19±6.5)d(P<0.05)。将改良的胃管置入空肠输出袢能有效的预防胰十二指肠切除术术后胃排空障碍的发生,有一定的临床推广价值。
引文
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[14]Tsnsks,Srrmgrr Mg role of the duodenum in the control of canine gagstrointestinal motility[J].Gastroenterol,1998,94(3):622-629.
[2]Schmidt CM,Powell ES,Yiannoutsos CT,et al.Pancreaticoduodenectomy:a 20-year experience in 516 patients[J].Arch Surg,2004,139(7):718.
[3]Shinji Osada,Hisashi Imai,Yoshiyuki Sasaki,et al.Re-construction method after pancreaticoduodenectomy.Idea to prevent serious complications[J].J Pancreas,2012,13(1):1-6.
[4]Neoptolemos J P,Stocken D D,Bassi C,et al.Adjuvant chemotherapy with fluorouracil plus folinic acid vs gemcitabine following pancreatic cancer resection[J].JAMA,2010,304(10):1073-1081.
[5]Hoshal Jr V L,Benedict M B,David L R,et al.Personal experience with the Whipple operation:outcomes and lessons learned[J].Am Surg,2004,70(2):121.
[6]Riediger H,Makowiec F,Schareck W D,et al.Delayed gastric emptying after pylorus-preserving pancreatoduodenectomy is strongly related to other postoperative complications[J].J gastrointest Surg,2003,7(6):758-765.
[7]周易冬,肖毅,赵玉沛.Whipple术后功能性胃排空障碍诊治问题的探讨[J].中华普通外科杂志,2002,17(11):671-672.
[8]Kawai M,Peretta S,Burckhardt O,et al.Endoscopic pyloromyotomy:a new concept of minimally invasive surgery for pyloric stenosis[J].Endoscopy,2012,44(2):169-173.
[9]Van der Voort IR,Osmanoglou E,Seybold M,et al.Electrogastrography as a diagnostic tool for delayed gastric emptying in functional dyspepsia and irritable bowel syndrome[J].Neurogastr Mot,2003,15(5):467-473.
[10]Greene JG,Noorian AR,Srinivasan S.Delayed gastric emptying and enteric nervous system dysfunction in the rotenone model of Parkinson's disease[J].Exp Neur,2009,218(1):154-161.
[11]Sanaka M,Yamamoto T,Kuyama Y.Effects of proton pump inhibitors on gastric emptying:a systematic review[J].Dig Dise Sci,2010,55(9):2431-2440.
[12]Ogawa A,Mochiki E,Yanai M,et al.Interdigestive migrating motor complex(IMC)is co-regulated with ghrelin and motilin in conscious dogs[J].Gastroenterol,2011,140(5):S-600.
[13]Tani M,Terasawa H,Kawai M,et al.Improvement of delayed gastric emptying in pylorus-preserving pancreaticoduodenectomy:results of a prospective,randomized,controlled trial[J].Ann Surg,2006,243(3):316.
[14]Tsnsks,Srrmgrr Mg role of the duodenum in the control of canine gagstrointestinal motility[J].Gastroenterol,1998,94(3):622-629.