胰腺癌术后胃排空障碍机制研究进展

季 昱东1, 崔红 元*2
1、青海大学研究生院
2、北京医院

摘要


胰腺癌患者术后常面临胃排空功能障碍这一临床挑战。虽然该并发症本身不直接危及生命，但其持续性存在可能引发系列临床问题：包括机体营养吸收障碍、医疗资源消耗增加以及术后抗肿瘤综合治疗的时机延误等。本文基于循证医学视角，通过系统梳理国际权威文献，重点探讨该并发症的临床机制，围手术期干预策略的最新研究动态，旨在为临床实践提供理论依据，通过实施精准化防治措施促进患者康复进程并保障后续治疗的连续性。

关键词


胃排空障碍；胰腺癌术后；机制

全文:

PDF


参考


[1]Walter D, Schnitzbauer A A, Schulze F, 等. The diagnosis and treatment of ampullary carcinoma[J]. Deutsches Arzteblatt International, 2023, 120(43): 729-735.

[2]Riediger H, Makowiec F, Schareck W D, 等. Delayed gastric emptying after pylorus-preserving pancreatoduodenectomy is strongly related to other postoperative complications[J]. Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract, 2003, 7(6): 758-765.

[3]Wente M N, Bassi C, Dervenis C, 等. Delayed gastric emptying (DGE) after pancreatic surgery: a suggested definition by the International Study Group of Pancreatic Surgery (ISGPS)[J]. Surgery, 2007, 142(5): 761-768.

[4]秦新裕，刘凤林.术后胃瘫的诊断与治疗[J].中华消化杂志，2005（7）：441-442.

[5]Bragg D, El-Sharkawy A M, Psaltis E, 等. Postoperative ileus: Recent developments in pathophysiology and management[J]. Clinical Nutrition (Edinburgh, Scotland), 2015, 34(3): 367-376.

[6]Ogawa A, Mochiki E, Yanai M, et al. Interdigestive migrating contractions are coregulated by ghrelin and motilin in conscious dogs[J]. American Journal of Physiology. Regulatory, Integrative and Comparative Physiology, 2012, 302(2): R233-241.

[7]孟凡宇，陈金明，史赢.胰十二指肠切除术后胃排空延迟相关因素分析[J].中国现代普通外科进展，2015，18（9）：692-694+700.

[8]Søfteland E, Brock C, Frøkjær J B, 等. Rectal sensitivity in diabetes patients with symptoms of gastroparesis[J]. Journal of Diabetes Research, 2014, 2014: 784841.

[9]Camilleri M, Chedid V, Ford A C, 等. Gastroparesis[J]. Nature Reviews. Disease Primers, 2018, 4(1): 41.

[10]Phillips L K, Deane A M, Jones K L, 等. Gastric emptying and glycaemia in health and diabetes mellitus[J]. Nature Reviews. Endocrinology, 2015, 11(2): 112-128.

[11]Hirao M, Fujitani K, Tsujinaka T. Delayed gastric emptying after distal gastrectomy for gastric cancer[J]. Hepato-Gastroenterology, 2005, 52(61): 305-309.

[12]林锡汉，庄丹，刘金炎，等.围手术期患者低蛋白血症与胃瘫的相关性研究[J].海南医学，2012，23（12）：27-29.

[13]Fraser R J, Horowitz M, Maddox A F, 等. Hyperglycaemia slows gastric emptying in type 1 (insulin-dependent) diabetes mellitus[J]. Diabetologia, 1990, 33(11): 675-680.

[14]姜薇，马秀萍，张芬茹，等.胃排空与糖尿病胃瘫[J].陕西医学杂志，1997（6）：366-367.

[15]Thuneberg L. Interstitial cells of cajal: Intestinal pacemaker cells?[J]. Advances in Anatomy, Embryology, and Cell Biology, 1982, 71: 1-130.

[16]Takaki M. Gut pacemaker cells: The interstitial cells of cajal (ICC)[J]. Journal of Smooth Muscle Research = Nihon Heikatsukin Gakkai Kikanshi, 2003, 39(5): 137-161.

[17]Serio R, Huizinga J D, Barajas-Lopez C, 等. Interstitial cells of cajal and slow wave generation in canine colonic circular muscle[J]. Journal of the Autonomic Nervous System, 1990, 30 Suppl: S141-143.

[18]舒磊，蔡志阳，刘曜安，等.Cajal间质细胞与慢传输型便秘的相关机制研究进展[J].中国医刊，2024，59（7）：720-723.

[19]Xu L, Gao S, Guo F, 等. Effect of motilin on gastric distension sensitive neurons in arcuate nucleus and gastric motility in rat[J]. Neurogastroenterology and Motility, 2011, 23(3): 265-270, e120-121.

[20]Goyal R K, Guo Y, Mashimo H. Advances in the physiology of gastric emptying[J]. Neurogastroenterology and Motility, 2019, 31(4): e13546.

[21]王茂，代引海，邱春丽，等.胃癌手术前后胃动素及胃泌素水平变化的研究[J].河南科技大学学报（医学版），2014，32（4）：251-252.

[22]Boivin M, Bradette M, Raymond M C, 等. Mechanisms for postprandial release of motilin in humans[J]. Digestive Diseases and Sciences, 1992, 37(10): 1562-1568.

[23]Glowka T R, Webler M, Matthaei H, 等. Delayed gastric emptying following pancreatoduodenectomy with alimentary reconstruction according to Roux-en-Y or Billroth-II[J]. BMC surgery, 2017, 17(1): 24.

[24]Dockray G, Dimaline R, Varro A. Gastrin: Old hormone, new functions[J]. Pflugers Archiv: European Journal of Physiology, 2005, 449(4): 344-355.

[25]Schaible A, Brenner T, Hinz U, et al. Significant decrease of mortality due to anastomotic leaks following esophageal resection: Management makes the difference[J]. Langenbeck’s Archives of Surgery, 2017, 402(8): 1167-1173.

[26]Tee M C, Croome K P, Shubert C R, et al. Laparoscopic pancreatoduodenectomy does not completely mitigate increased perioperative risks in elderly patients[J]. HPB, 2015, 17(10): 909-918.

[27]JenningsG L，徐鹏远.内毒素对胃肠通过时间及肠通透性的作用[J].中国临床营养杂志，1998（2）：49-54.

[28]史洪涛，冷恩仁，陈东风.胃肠动力与肠源性内毒素血症关系的动物实验研究[J].第三军医大学学报，2001（10）：1249-1250.

[29]Wirthlin D J, Cullen J J, Spates S T, 等. Gastrointestinal transit during endotoxemia: The role of nitric oxide[J]. The Journal of Surgical Research, 1996, 60(2): 307-311.

[30]Joshua D. Beane, Michael L. Kendrick, Mark J. Truty, et al. “Operative Time in Pancreaticoduodenectomy: Does Surgeon Experience Modify the Impact on Outcomes?”[C]. Annals of Surgery, 2023: e345-e353.


Refbacks

  • 当前没有refback。