胃癌术后胃瘫的诊断和治疗
Diagnosis and Treatment of Postoperative Gastroparesis for Gastric Cancer
DOI: 10.12677/ACM.2022.1281057, PDF,   
作者: 聂世笛:延安大学,第一临床医学院,陕西 延安;白铁成*:延安大学附属医院,胃肠疝外科,陕西 延安
关键词: 术后胃瘫胃瘫综合症胃癌术后Postoperative Gastroparesis Gastroparesis Syndrome Postoperative Gastric Cancer
摘要: 以胃排空延迟为主要症状的综合征一般称之为胃瘫,其中腹胀、恶心和呕吐是胃轻瘫的主要症状。胃瘫的病因一般比较复杂,对患者的生活质量也会有很大的影响,还会延长住院时间,从而导致病床周转的速率变缓,进而加重医疗资源的消耗,因此患者的经济负担一般都比较重。在胃瘫中,特发性胃轻瘫是最常见的胃排空障碍,约占36%,其次是糖尿病(29%)和术后胃排空障(13%),本文聚焦于胃癌术后导致胃瘫的危险因素以及诊断和治疗。
Abstract: The syndrome with delayed gastric empty is commonly referred to as gastroparesis, in which ab-dominal distention, nausea and vomiting are the main symptoms of gastroparesis. The etiology of gastroparalysis is generally complex, which will also have a great impact on the quality of life of pa-tients. It will also prolong the length of hospital stay, which will slow down the rate of bed turnover and increase the consumption of medical resources. Therefore, the economic burden of patients is generally heavy. In gastric palsy, idiopathic gastroparesis is the most common gastric emptying disorder, accounting for 36%, followed by diabetes mellitus (29%) and postoperative gastric emp-tying disorder (13%). This article focuses on the risk factors, diagnosis and treatment of postopera-tive gastric palsy.
文章引用:聂世笛, 白铁成. 胃癌术后胃瘫的诊断和治疗[J]. 临床医学进展, 2022, 12(8): 7319-7325. https://doi.org/10.12677/ACM.2022.1281057

参考文献

[1] Simon-Weidner, R. (1953) Postoperative Stomach Atony after Stomach Resections. Zentralblatt Fur Chirurgie, 78, 353-362.
[2] Germanovskii, I.I. and Astakhova, E.I. (1951) Roentgenologic Investigation on the Gastric Evacuant Function in Gastroparesis. Klinicheskaia Meditsina, 29, 35-41.
[3] Meillier, A. and Patel, S. (2017) Readability of Healthcare Literature for Gastroparesis and Evaluation of Medical Terminology in Reading Difficulty. Gastroenterology Research, 10, 1-5. [Google Scholar] [CrossRef] [PubMed]
[4] 王雄飞, 刘春庆, 邵建平, 赵磊, 朱泽卫, 等. 腹腔镜胃癌根治术后胃瘫综合征的危险因素分析[J]. 武汉大学学报(医学版), 2022, 43(3): 423-426.
[5] 夏春华. 胃癌患者胃大部切除术后发生胃瘫综合征的影响因素[J]. 河南医学研究, 2021, 30(33): 6223-6225.
[6] Parkman, H.P., Hasler, W.L., Fisher, R.S. and American Gastroenterological Association (2004) American Gastroenterological Associa-tion Medical Position Statement: Diagnosis and Treatment of Gastroparesis. Gastroenterology, 127, 1591-1589. [Google Scholar] [CrossRef] [PubMed]
[7] 胡俊杰, 熊治国. 胃癌远端胃切除术后消化道重建手术方式选择的再思考[J]. 临床外科杂志, 2019, 27(5): 376-378.
[8] 王恒雨, 尚现章, 张杰. 远端胃切除术后消化道重建方式的研究进展[J]. 腹部外科, 2018, 31(5): 372-375.
[9] 袁红, 赵玲辉. 胃壁的神经分布与溃疡病[J]. 解剖科学进展, 1996(4): 326-331.
[10] 任书瑶, 王东旭. 经口内镜幽门肌切开术在治疗胃轻瘫中的应用及研究现状[J]. 中华消化内镜杂志, 2018, 35(8): 601-605.
[11] Hong, J., Wang, S. and Hao, H. (2019) A Comparative Study of Dou-ble-tract Reconstruction and Roux-en-y after Gastrectomy for Gastric Cancer. Surgical Laparoscopy, Endoscopy & Per-cutaneous Techniques, 29, 82-89. [Google Scholar] [CrossRef
[12] Sanders, K.M., Kito, Y., Hwang, S.J. and Ward, S.M. (2016) Regulation of Gastrointestinal Smooth Muscle Function by Interstitial Cells. Physiology, 31, 326-316. [Google Scholar] [CrossRef] [PubMed]
[13] 贺宏勇, 席艳峰, 李豪杰, 叶博天, 刘凤林. 腹腔镜胃癌根治术十二指肠残端采用单荷包缝合加固的疗效观察[J]. 中华胃肠外科杂志, 2019(8): 762-766.
[14] Rupani, S.V., Ergen, W.F., Weber, F. and Peter, S. (2018) Direct Percutaneous Endoscopic Jejunostomy for the Management of Gas-troparesis in Pregnancy. Obstetrics & Gynecology, 131, 871-874. [Google Scholar] [CrossRef
[15] 李季, 杨韵霏, 张军. 腹腔镜胃癌根治术中吻合方式和消化道重建的现状[J]. 医学信息, 2020, 33(8): 43-47.
[16] 陈烈欢, 程龙庆, 彭翔, 周永辉, 李泳, 黄上嘉, 等. 腹腔镜远端胃癌根治术后胃瘫综合征的危险因素及对患者预后影响分析[J]. 实用中西医结合临床, 2019, 19(12): 51-53.
[17] Zhang, X., Yin, G., Liu, Q., Liu, X.M., Wang, B., Yu, L., et al. (2014) Does Braun Enteroenterostomy Re-duce Delayed Gastric Emptying after Pancreaticoduodenectomy? Medicine, 93, e48. [Google Scholar] [CrossRef
[18] Di vita, G., Costa, R., Siragusa, G., Asaro, M., Aragona, S., Scaffidi, A., et al. (1991) Gastric Emptying after Duodenogastric Resection. Annali Italiani Di Chirurgia, 62, 159-163.
[19] 马有伟, 刘宏斌, 韩晓鹏, 等. 毕II式联合Braun吻合与单纯毕II式吻合在全腹腔镜下远端胃癌根治术中的疗效比较[J]. 中国普外基础与临床杂志, 2016, 23(3): 311-314.
[20] 陕陈鹏, 董永红. 胃癌根治性切除术后胃瘫综合征研究进展[J]. 世界最新医学信息文摘, 2018(18): 65-66+68.
[21] Bandelow, B. and Michaelis, S. (2015) Epidemiology of Anxiety Disorders in the 21st Century. Dialogues in Clinical Neuroscience, 17, 35-327. [Google Scholar] [CrossRef
[22] 刘辉, 黄陶承, 蔡元坤, 张厚康. 腹部手术后胃瘫的原因及诊治(附16例报告) [J]. 中国临床医学, 2003, 10(3): 297-298.
[23] Gotfried, J. and Schey, R. (2017) Un-derstanding the Differences between Gastroparesis and Gastroparesis-like Syndrome: Filling a Gaping Hole? Digestive Diseases and Sciences, 62, 2615-2617. [Google Scholar] [CrossRef] [PubMed]
[24] 郭鹏, 马东红, 黄博. 根治性胃大部切除术后残胃排空障碍的研究现状[J]. 中华临床医师杂志(电子版), 2017(9): 1587-1590.
[25] Bharucha, A.E., Kudva, Y.C. and Prichard, D.O. (2019) Diabetic Gastroparesis. Endocrine Reviews, 40, 1318-1352. [Google Scholar] [CrossRef] [PubMed]
[26] Shen, S., Xu, J., Lamm, V., Vachaparambil, C.T., Chen, H., Cai, Q., et al. (2018) Diabetic Gastroparesis and Nondiabetic Gastroparesis. Gastrointestinal Endoscopy Clinics of North America, 29, 15-25. [Google Scholar] [CrossRef] [PubMed]
[27] Camilleri, M., Parkman, H.P., Shafi, M.A., Abell, T.L. and Gerson, L. (2013) Clinical Guideline: Management of Gastroparesis. The American Journal of Gastroenterology, 108, 18-37. [Google Scholar] [CrossRef] [PubMed]
[28] Navas, C.M., Patel, N.K. and Lacy, B.E. (2017) Gastroparesis: Medical and Therapeutic Advances. Digestive Diseases and Sciences, 62, 2231-2240. [Google Scholar] [CrossRef] [PubMed]
[29] 秦新裕, 刘凤林. 术后胃瘫综合征的发病机制和治疗[J]. 诊断学理论与实践, 2006(1): 13-15.
[30] Zhang, Q.,Yu, J., Ma, Z., Kang, W.M., Ke, M.Y. and Qian, J.M. (2006) The Effects of Enteral Nutrition vs Parenteral Nutrition on Gastric Motility and Gastroenteric Hormones after Subtotal Gas-trectomy: A Perspective Randomized Compared Clinical Trial. Chinese Journal of Surgery, 44, 32-728.
[31] Rao, A.S. and Camilleri, M. (2010) Review Article: Metoclopramide and Tardive Dyskinesia. Alimentary Pharmacology & Thera-peutics, 31, 9-11. [Google Scholar] [CrossRef] [PubMed]
[32] Quigley, E.M. (2011) Cisapride: What Can We Learn From the Rise and Fall of a Prokinetic? Journal of Digestive Diseases, 12, 56-147. [Google Scholar] [CrossRef] [PubMed]
[33] Altan, E., Masaoka, T., Farré, R. and Tack, J. (2012) Acotiamide, a Novel Gastroprokinetic for the Treatment of Patients with Functional Dyspepsia: Postprandial Distress Syndrome. Expert Review of Gastroenterology & Hepatology, 6, 533-544. [Google Scholar] [CrossRef] [PubMed]
[34] 申红超, 衣哲, 陈美晓, 梁琪. 针刺治疗腹部手术后胃瘫综合征25例[J]. 中医外治杂志, 2022, 31(1): 85-87.
[35] 李天传, 陈乃杰, 陈云莺, 张劭琴. 理气消痞汤治疗腹部肿瘤手术后胃瘫综合征临床观察[J]. 光明中医, 2022, 37(7): 1206-1209.
[36] 崔艺馨, 王德财, 陈格格, 王海明, 张印, 林明雄. 温阳活血中药外敷治疗消化系统肿瘤术后胃瘫综合征的临床研究[J]. 中国医药, 2021, 16(9): 1355-1359.
[37] Brewer Gutierrez, O.I. and Khashab, M.A. (2019) Stent Placement for the Treatment of Gastroparesis. Gastrointestinal Endoscopy Clinics of North America, 29, 107-115. [Google Scholar] [CrossRef] [PubMed]
[38] Zihni, A.M., Dunst, C.M. and Swanström, L.L. (2019) Surgical Management for Gastroparesis. Gastrointestinal Endoscopy Clinics of North America, 29, 85-95. [Google Scholar] [CrossRef] [PubMed]