摘要
目的探讨胃大部切除术后功能性排空障碍的临床特点及可能的发病机制。方法计算机检索中文生物医学数据库(CBMdisc)、万方数据库、维普数据库及中国知网数据库,检索年限均从建库到2008年12月,手工检索纳入文献及其参考文献、会议论文集、学位论文汇编等。按Cochrane系统评价方法筛选试验、评价纳入研究的方法学质量、提取资料,进行Meta分析。结果17篇文献符合纳入标准,包括238例患者。研究结果:①功能性排空障碍患者的男女比例约为2∶1,平均年龄约为53岁;②238例患者中接受毕Ⅰ式手术者46例,接受毕Ⅱ式手术者(包括Roux-Y吻合术)192例,比例约为1∶4,功能性排空障碍发生率为3.2%～7.0%;③功能性排空障碍的临床表现主要包括上腹部饱胀不适、恶心呕吐、顽固性呃逆及胃肠减压或呕吐后症状缓解等;④功能性排空障碍的治愈率约为98%。结论胃大部切除术后功能性排空障碍是胃大部切除术后的主要近期并发症之一,临床诊断应结合患者的临床症状及发病特点,其治疗手段首选保守治疗。
Objective To investigate the clinical features and pathogenesis of functional delayed gastric emptying after gastrectomy （FDGE）. Method Based on the principles and methods of Cochrane systematic reviews, we searched CBMdisc, VIP, Wanfang and CNKI databases, from inception to Dec. 2008, and we also hand-searched relevant journals and conference proceedings. We evaluated the risk of the bias of the included RCTs according to the Cochrane Handbook for Systematic Reviews. Results 17 trials （a total of 238 participants） were included. Main results： （1）The proportion of male and female of FDGE was about 2： 1, the average age about 53-year-old; （2）46 patients with Billroth- Ⅰ surgery and 192 patients with Billroth-Ⅱ surgery （including the Roux-Y anastomosis） in 238 participants, the ratio was about 1：4, and the incidence was 3.2%-7.0%; （3） The main elinical features of FDGE included： abdominal fullness, diseomfort, nausea and vomiting, ete; （4）The cure rate of FDGE was about 98%. Conclusions FDGE is one of the main complications after subtotal gastrectomy. Clinical diagnosis of FDGE should be combined with clinical symptoms and signs. The main treatment means of FDGE is conservative treatment.
出处
《循证医学》
CSCD
2010年第1期43-45,64,共4页
The Journal of Evidence-Based Medicine
基金
教育部新世纪优秀人才支持计划(编号:NCET-06-0296)
关键词
功能性排空障碍
胃大部切除术
系统评价
functional delayed gastric emptying
gastrectomy
systematic review
