中国中西医结合消化杂志2023年·188·Chin J Integr Trad West Med Dig31卷3期·指南与此识·中国肿瘤患者术后胃瘫诊治中西医结合专家共识(2022版)*中国研究型医院学会[摘要]术后胃瘫综合征是腹部手术后常见的并发症之一，一股是由非机械性梗阻因素引起，以胃排空障碍为主要征象的胃动力紊乱综合征，严重影响患者的生活质量，同时导致住院时间延长、住院费用增加，术后胃瘫的发生可能与交感神经激活、胃十二指肠运动失调以及内环境素乱有关，是包括手术方式和消化道重建在内的多种因素综合作用的结果，胃瘫的诊断以临床表现和影像学等辅助检查发现胃猪留和胃排空延迟为主，目前胃瘫的治疗主要是中西医保守治疗，包括促胃肠动力药物、中药和针灸的联合治疗以及多种治疗措施的综合治疗，[关键词]胃肿瘤：胃瘫综合征：发病原因：诊断：治疗D01:103969/j.issm1671-038X.20230307[中图分类号]273[文献标志码]AChinese expert consensus on diagnosis and treatment of postoperativegastroparesis syndrome in cancer patients with TraditionalChinese and Western Medicine(2022 edition)China Research Hospital AssociationCorresponding author:LI Quanwang,E-mail:quanwangli@126.com;ZHANG Xuezhi,E-mail:zhang.xuezhi@263.net:XIE Yibin,E-mail:yibinxie2003@163.comAbstract Postoperative gastroparesis syndrome is one of the common complications after abdominal surgery.It is generally a gastric motility disorder syndrome with gastric emptying disorder as the main symptom caused bynon-mechanical obstructive factors,which seriously affects the quality of life of patients,resulting in prolongedhospitalization and increased costs.The occurrence of postoperative gastroparesis may be related to sympatheticnerve activation,gastroduodenal motility disorder,and internal environment disturbance,which is the result ofthe combined effects of various factors,including surgical approaches and digestive tract reconstruction.The diag-nosis of gastroparesis is mainly based on the findings of gastric retention and delayed gastric emptying by clinicalmanifestations and auxiliary examinations such as imaging.The current treatment plan for gastroparesis is mainlyconservative treatment of Traditional Chinese and Western Medicine,including gastrointestinal motility drugs,combined treatment of Traditional Chinese Medicine and acupuncture,and comprehensive treatment of varioustreatment measures.Key words gastric cancer:gastroparesis syndrome:etiology:diagnosis:treatment1胃瘫在肿瘤患者中的流行病学情况远端胃癌切除术后其发病率为4%~5%]。目胃瘫综合征是腹部手术后早期常见的并发症，前，胃瘫的发病机制尚不十分明确。主要发生在胃十二指肠术后，也可发生在非胃十二2胃瘫的可能成因指肠手术中，是一种具有胃动力障碍和胃肠道非机2.1术后并发症械性阻塞特征的功能性疾病四。其发病率随着手①近端胃切除时，迷走神经被切断，位于胃大术的展开和手术时间的延长而增加。据报道，胰十弯中上1/3的胃蠕动“起搏点”被切除，使胃的正常二指肠切除术后胃瘫的发生率可达20%~50%，蠕动和排空受到抑制可；②远端胃切除时，切除了*基金项日：吴阶平医学基全会格床科研专项资助基金(N0:320.6750.2022-0319)执笔人：丁世康，中国医学科学院肿骑医院镜胃外补，Emil:dsk11172019@163.c0m:叶辉，北京大学第一医院中医中西医结合科，E-mail:yhui@pk ufh.com:周琴，北京中医药大学东方医院钟骑科，E-mail:qinzi0424@126.com通信作者：李泉旺，北京中医药大学东方医院，E-mail:quanwangli@l26.com:张学智，北京大学第一医院，E-mail:hang.xuezhi(@263.net:解亦试，国家摇症中心中国医学朴学院肿骑医院，E-mail:yibinxie.2003@163.com引用本文：中国研究型医院学会.中国肿瘤忠者术后胃瘫诊治中西医结合专家共识(2022版)[J门.中国中西医结合消化杂志，2023,31(3)：188191.D01:10.3969/j.issn1671-038X.20230307.
