目的 总结腹部手术后胃瘫综合征(PGS)的病因、诊断及治疗方法。方法回顾性分析我院2003年1月至2009年3月期间行腹部手术后发生胃瘫的30例患者的临床资料。结果 PGS发生于术后5~10 d,通过临床表现、上消化道造影及胃镜检查明确诊断。全组均经营养支持、药物治疗等保守治疗后治愈,治愈时间14~62 d,平均25 d。结论 PGS是由多种因素导致的,上消化道造影及胃镜检查是诊断PGS的可靠方法,保守治疗为其主要治疗手段,应尽量避免再次手术。
Objective To summarize clinical diagnosis and treatment of 1 case of hypothyroidism complicated with postoperative gastroparesis syndrome (PGS) after radical resection of right colon cancer. Method The multi-disciplinary (MDT) mechanism was used to discuss the MDT consultations of the departments of general surgery, endocrinology, nutrition, radiology, and pathology in a patient with hypothyroidism and right colon cancer after the radical resection. Results The MDT discussion concluded that the patient had a clear diagnosis of right colon cancer before the surgery, and the PGS occurred after the radical resection of right colon cancer. The patient had the hypothyroidism before the operation, and the occurrence of PGS might be related to the hypothyroidism. The experts of MDT recommended to treat with the thyroxine sodium and nutritional support treatment after the surgery. According to the results of the MDT discussion, the patient’s PGS was gradually cured and discharged smoothly after the thyroxine supplementation and nutritional support. Conclusions Hypothyroidism may be a risk factor for occurrence of PGS after radical resection of right colon cancer. MDT mechanism can provide an individualized optimal treatment for patients with hypothyroidism complicated with PGS after radical resection of right colon cancer and benefit these patients.