Cinical Analysis And Treatment Of Postsurglcal Gastroparesis Syndrome(PGS) After Billroth Ⅱ Distal Subtotal Gastrectomy

Objective: PGS may be caused by a variety of diseases,but etiology mechanismsare not fully understood now.This research is to find out the incidence of PGS afterBillroth Ⅱdistal subtotal gastrectomy, analyzed and summarized clinicopathologicalfeatures, diagnosis and treatment of PGS,discuss the risk factors of PGS for our hospitalto gastroparesis prevention and treatment of reference.Methods: This study select the457cases with Billroth Ⅱdistal subtotalgastrectomy in the First Hospital of Dalian Medical University from2010.01to2013.1.PGS patients were classified as PGS group and control group which according togastroplegia syndrome diagnostic criteria combined with clinical data such as medicalhistory, symptoms, signs and laboratory examinations, record the diagnosis andtreatment process.Retrospectively analyzed the clinicopathological features, diagnosisand treatment and compared.Results: The incidence of PGS was5.03%. Through the comparison of thesingle factors between the PGS group and the control group，gender（p=0.019）,age≥65years(p=0.013),BMI≥25(p=0.001), Postoperative protein<30g/l(p=0.006),mental factor(p=0.000)and postoperation(p=0.037),which all show significant statistically differences,and all of which are the high risk factors of getting PGS after the surgery. In the PGS group, to analyze the single factors,the patients are divided into two groups based on the surgical factor, personal factor, treatments andso on (base on the course of PGS，≤30days and≥30days). The results show that using Energy mixturecan significantly shorten the course of PGS（p=0.005）,the maximum diameter of the tumor may affect the course of PGS(the average maximum diameter of the tumor in the group≤30days is4.75±1.66, the other is3. 07±1.03)Conclusion: The PGS after operation often bring spiritual and economic burden topatients, and increased hospitalization period. The data show that the patient’s gender,age, BMI, psychological factors, postoperative hypoproteinemia, using the high sugarand transfusion after operation are risk factors of postoperative PGS. The tumor isbigger, the course of PGS isn longer. The application of energy mixture can be able toshorten the course and clinical work in patients with above characteristics should payattention to the prevention of the occurrence of PGS, enhanceing postoperative albumingiven, strengthing the postoperative glycemic control. To the patients of postoperativePGS can give some drug to suppress nausea and vomiting, abdominal pain. Theapplication to promote gastrointestinal motility drugs and energy mixture can shortenthe PGS course.