远端胃切除术后胃瘫发生的胃电图研究
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摘要
目的:探讨胃电图在远端胃切除术后预测胃瘫发生中的临床意义。方法:47例远端胃切除患者根据术后是否发生胃瘫分为胃瘫组及对照组。比较两组术前及术后72 h、96 h、120 h体表胃电图的差异。同时对47例患者进行上腹部临床症状分度评分和生化指标检测。结果:与对照组相比,胃瘫组术后各阶段正常胃电慢波百分比均有升高趋势,手术前后各阶段胃电振幅均值均有不同程度减小;胃瘫组在术后72 h的恶心、呕吐和反酸评分均较对照组显著升高(P<0.01);胃瘫组术前血红蛋白和总胆红素含量均显著低于对照组(P<0.01和P<0.05),术后的白细胞计数显著高于对照组(P<0.01)。结论:胃电图参数结合上腹部临床症状分度评分和生化指标对腹部术后发生胃瘫可能性有一定参考。
Objective: To discuss the clinical value of electrogastrogram(EGG) in predictingpost-operative gastroparesis through EGG, clinical symptom score for Upper abdominal and Biochemical indexes in patients with gastroparesis after distal gastrectomy. Methods: 47 patients who underwent distal gastrectomy were divided in two groups based on the occurrence of gastroparesis.EGG was tested at pre-operation and 72 h,96 h,120 h post-operation. The clinical symptom score for Upper abdominal and Biochemical indexes were recorded before and after operation. Results:Compared with the control group, the EGG N% of gastroparesis group showed increasing trend after operation, the EGG amplitude mean of gastroparesis group showed decreasing trend duiring pre and post-operation; the nausea, vomiting and regurgitation scores of gastroparesis group at 72 h post-operation were significantly increased compared with the control group(P <0.01); the hemoglobin and total bilirubin of gastroparesis group were significantly lower than control group at preoperation(P <0.01 and P <0.05), and the white blood cell count was significantly higher than control group after operation(P <0.01). Conclusions: EGG parameters combined with the upper abdominal clinical symptom score and biochemical indicators have a certain reference to the occurrence of gastroparesis after abdominal surgery.
Objective: To discuss the clinical value of electrogastrogram(EGG) in predictingpost-operative gastroparesis through EGG, clinical symptom score for Upper abdominal and Biochemical indexes in patients with gastroparesis after distal gastrectomy. Methods: 47 patients who underwent distal gastrectomy were divided in two groups based on the occurrence of gastroparesis.EGG was tested at pre-operation and 72 h,96 h,120 h post-operation. The clinical symptom score for Upper abdominal and Biochemical indexes were recorded before and after operation. Results:Compared with the control group, the EGG N% of gastroparesis group showed increasing trend after operation, the EGG amplitude mean of gastroparesis group showed decreasing trend duiring pre and post-operation; the nausea, vomiting and regurgitation scores of gastroparesis group at 72 h post-operation were significantly increased compared with the control group(P <0.01); the hemoglobin and total bilirubin of gastroparesis group were significantly lower than control group at preoperation(P <0.01 and P <0.05), and the white blood cell count was significantly higher than control group after operation(P <0.01). Conclusions: EGG parameters combined with the upper abdominal clinical symptom score and biochemical indicators have a certain reference to the occurrence of gastroparesis after abdominal surgery.
引文
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[11]张怀华,吴本国,杜滨亮.胃癌根治术后胃瘫综合征的危险因素分析及其对预后的影响[J].中国现代普通外科进展,2016,19(3):248-249.
[2]蔡一亭,秦新裕.根治性胃大部切除术后胃瘫15例临床分析[J].中国实用外科杂志,1999,(6):338-340.
[3]刘全达,蔡志民,余佩武,等.腹部术后胃瘫的诊断和治疗[J].中国普通外科杂志,2001,10(6):524-527.
[4]周吕,柯美云.胃肠动力学:基础与临床[M].科学出版社,1999:360-366.
[5]Stanciu GO.Gastroparesis and its management[J].Revista medicochirurgicala a Societatii de Medici si Naturalisti din Iasi,2001,105(3):451.
[6]连至诚,陈苇菁,邓钰英,等.胃肠电检测分析系统的原理结构及临床意义研究[J].临床医学工程,2003(11):22-27.
[7]张声生,汪红兵,李乾构.功能性消化不良中医诊疗规范(草案)[J].中国中西医结合消化杂志,2002,10(4):194.
[8]陕飞,季加孚.腹部手术后胃瘫综合征的诊治进展[J].中国实用外科杂志,2013,(4):340-343.
[9]江志伟,李宁,黎介寿.快速康复外科的概念及临床意义[J].中国实用外科杂志,2007,27(2):131-133.
[10]Chen JD,Lin Z,Pan J,et al.Abnormal gastric myoelectrical activity and delayed gastric emptying in patients with symptoms suggestive of gastroparesis[J].Dig Dis Sci,1996,41(8):1538-1545.
[11]张怀华,吴本国,杜滨亮.胃癌根治术后胃瘫综合征的危险因素分析及其对预后的影响[J].中国现代普通外科进展,2016,19(3):248-249.