脊柱手术对胃功能的影响及相关治疗的疗效研究

作者	单位
林向进	浙江大学医学院附属第一医院!杭州310003
吴嘉庚	浙江大学医学院附属第一医院!杭州310003
杜峻华	浙江大学医学院附属第一医院!杭州310003

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中文摘要:

目的 :研究脊柱手术对胃功能的影响及相关治疗的疗效。方法 :60例脊柱手术患者 ,2 0例四肢手术患者 ,2 0名健康者 ,脊柱手术组术前及术后均行胃电图检查 ,其中 2 0例行X线钡餐造影动态胃蠕动波记录。脊柱手术组术后随机分为 3组 ,分别予中药香砂养胃丸、艾灸、吗丁啉治疗 ,同时观察比较治疗前后胃电图变化。结果 :脊柱手术组术后胃电节律有明显异常 ,频率和振幅与其他两组差异有显著性 (P <0 0 5,P <0 0 1) ,胃蠕动波明显减弱 ,排空时间延长。经治疗后 ,胃电图检查均有明显改善 (P <0 0 5) ,中药组疗效优于其他两组 ,但差异无显著性。结论 :脊柱手术可影响胃电节律 ,导致胃功能紊乱 ,易引起胃轻瘫 ,胃电图检查对此具有满意的诊断价值。中药香砂养胃丸、艾灸、吗丁啉治疗脊柱术后胃功能紊乱均有效

英文摘要:

Objective: To study the effect of spine surgery (SpS) on gastric function and the efficacy of relevant treatments. Methods: Sixty patients in the spine surgery group, 20 patients in the extremity surgery (ES) group and 20 healthy subjects in the control group were observed. Electrogastrography (EGG) was used to observe gastroelectric activity before and after operation. Twenty patients among the SpS group were examined with barium meal under actinoscopy to observe the gastric peristaltic waves before and after operation. The SpS group was randomly subdivided into 3 groups, and treated by Xiangsha Yangwei pill (XSYW), moxibustion and motilium respectively. At the same time, the EGG of various groups was observed and the change of preoperative and postoperative EGG were compared. Results: The gastroelectric rhythm of SpS group was remarkably abnormal, both frequency and amplitude of EGG were significantly different from the other two groups (P<0 05, P<0 01). The gastric peristaltic waves were reduced, and the emptying time was obviously prolonged. EGG was significantly improved after either of the three treatments statistically (P<0 05), the effect of XSYW was the best, but in comparing with the other two, the difference was not significant (P>0 05). Conclusion: SpS could change the gastroelectric rhythm to cause the gastric functional disorder and induce gastroparesis, EGG can get satisfactory result in the diagnosis of these illnesses. XSYW, moxibustion and motilium all have significant effects on the gastric function after SpS.

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