推荐回答(5个)
你可以通过
情况差的老年人,可作胃空肠吻合术。
1.非手术疗法:由幽门痉挛或炎症水肿所致梗阻,应以非手术治疗,方法是:胃肠减压,保持水电解质平衡及全身支持治疗。
2.手术疗法:瘢痕所致幽门梗阻和非手术治疗无效的幽门梗阻应视为手术适应症。手术的目的是解除梗阻,使食物和胃液能进入小肠,从而改善全身状况。常用的手术方法有:(1)胃空肠吻合术:方法简单,近期效果好,死亡率低,但由于术后吻合溃疡发生率很高,故现在很少采用。对于老年体弱,低胃酸及全身情况极差的患者仍可考虑选用。(2)胃大部切除术:如患者一般情况好,在我国为最常用的术式。(3)迷走神经切断术:迷走神经切断加胃窦部切除术或迷走神经切断加胃引流术,对青年患者较适宜。(4)高选择性迷走神经切断术:近年有报道高选择性迷走神经切除及幽门扩张术,取得满意效果。幽门梗阻患者术前要作好充分准备。术前2~3天行胃肠减压,每日用温盐水洗胃,减少胃组织水肿。输血、输液及改善营养,纠正水电解质紊乱。
幽门梗阻为溃疡病最常见的并发症,多见于十二指肠溃疡,偶可见于幽门管或幽门前区溃疡。据统计在十二指肠溃疡中发生幽门梗阻者约占8%,而在胃溃疡中仅占2%左右。
病因
溃疡病并发幽门梗阻有四种:
1.痉挛性梗阻:幽门附近溃疡,刺激幽门括约肌反射性痉挛所致。
2.炎症水肿性梗阻:幽门区溃疡本身炎症水肿。
3.瘢痕性梗阻:溃疡胼胝硬结,溃疡愈后瘢痕挛缩。
4.粘连性梗阻:溃疡炎症或穿孔后引起粘连或牵拉。
症状
1.呕吐:呕吐是幽门梗阻的突出症状,其特点是:呕吐多发生在下午或晚上,呕吐量大,一次可达一升以上,呕吐物为郁积的食物,伴有酸臭味,不含胆汁。呕吐后感觉腹部舒服,因此病人常自己诱发呕吐,以缓解症状。
2.胃蠕动波:上腹可隆起的胃型,有时见到胃蠕动波,蠕动起自左肋弓下,行向右腹,甚至向相反方向蠕动。
3.震水音:胃扩张内容物多,用手叩击上腹时,可闻及水震荡声。
4.其他:尿少、便秘、脱水、消瘦,严重时呈现恶液质。
检查
有长期溃疡病史的患者和典型的胃潴留及呕吐症状,必要时进行X线或胃镜检查,诊断不致困难。
1.非手术疗法
幽门痉挛或炎症水肿所致梗阻,应以非手术治疗,方法是:胃肠减压,保持水电解质平衡及全身支持治疗。
2.手术疗法
瘢痕所致幽门梗阻和非手术治疗无效的幽门梗阻应视为手术适应症。手术的目的是解除梗阻,使食物和胃液能进入小肠,从而改善全身状况。常用的手术方法有:
(1)胃空肠吻合术:法简单,近期效果好,死亡率低,但由于术后吻合溃疡发生率很高,故现在很少采用。对于老年体弱,低胃酸及全身情况极差的患者仍可考虑选用。
(2)胃大部切除术:患者一般情况好,在我国为最常用的术式。
(3)迷走神经切断术:迷走神经切断加胃窦部切除术或迷走神经切断加胃引流术,对青年患者较适宜。
(4)高选择性迷走神经切断术:年有报道高选择性迷走神经切除及幽门扩张术,取得满意效果。
幽门梗阻患者术前要作好充分准备。术前2~3天行胃肠减压,每日用温盐水洗胃,减少胃组织水肿。输血、输液及改善营养,纠正水电解质紊乱。
如果有幽门梗阻就需要及时去医院治疗的,否则就容易引起不良后果的。一般药物治疗是不能根治的,建议你应该去医院手术治疗才能解除梗阻的。
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