腹腔镜辅助胃癌根治术不留置胃管对缩短术后住院时间及降低肺部并发症发生率影响研究

Laparoscopic-assisted Radical Gastric Cancer Surgery without Indwelling a Gastric Tube on the Effect of Shortening the Postoperative Hospital Stay and Reducing the Incidence of Pulmonary Complications

目的探讨腹腔镜辅助胃癌根治术中采取不留置胃管的方法对于患者术后住院时间及肺部并发症发生率的影响。方法抽取行择期腹腔镜根治术的胃癌患者236例,均为本院外科2017年5月—2020年5月收治,采用数字表抽取法随机分为试验组(不留置胃管,118例)和对照组(留置胃管,118例),比较二者手术及术后恢复情况(手术时间、术后首次通气、排便以及住院时间)、术后并发症情况(肺部感染、吻合口漏、腹腔出血、胸腔积液、咽喉疼痛、腹腔出血等)。结果试验组与对照组所记录手术时间比较差异无统计学意义(P>0.05),术后首次通气、排便以及术后住院时间记录,试验组均较对照组缩短,差异有统计学意义(P<0.05);试验组与对照组在吻合口漏、切口愈合延迟、十二指肠残端漏、肠梗阻、恶心呕吐以及血栓栓塞方面,差异无统计学意义(P>0.05);肺炎、咽喉疼痛、胸腔积液方面,试验组的发生率低于对照组,差异有统计学意义(P<0.05)。结论针对择期行腹腔镜辅助胃癌根治术的患者,采用不留置胃管的方式,可使其康复进程加快,同时降低术后肺部感染、胸腔积液等并发症发生几率,推荐使用。

Objective To investigate the influence of the method without indwelling a gastric tube during laparoscopic-assisted radical gastric cancer surgery on the postoperative hospital stay and the incidence of pulmonary complications.Methods A total of 236 patients with gastric cancer who underwent elective laparoscopic radical mastectomy were selected,all of whom were admitted to the hospital from May 2017 to May 2020,and were randomly divided into experimental groups(without indwelling gastric tube,118 cases)Compared with the control group(indwelling gastric tube,118 cases),the two operations and postoperative recovery(operation time,first postoperative ventilation,defecation and hospitalization time),postoperative complications(pulmonary infection,anastomotic leakage,Abdominal bleeding,pleural effusion,sore throat,abdominal bleeding,etc.).Results There was no significant difference between the operation time recorded in the experimental group and the control group(P>0.05).The first ventilation,defecation and postoperative hospital stay were recorded in the experimental group compared with the control group.The difference was statistically significant(P<0.05);there was no significant difference between the test group and the control group in terms of anastomotic leakage,delayed incision healing,duodenal stump leakage,intestinal obstruction,nausea and vomiting,and thromboembolism(P>0.05);pneumonia,throat In terms of pain and pleural effusion,the incidence of the test group was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion For patients undergoing elective laparoscopic-assisted radical gastric cancer surgery,the use of no indwelling gastric tube can speed up the recovery process and reduce the incidence of postoperative complications such as lung infection and pleural effusion.It is recommended.