留置鼻胃管在胃癌术后临床应用的前瞻性随机试验

Evaluation of nasogastric decompresion in postoperative gastric cancer patients:a prospective randomized trial

目的探讨留置鼻胃管在胃癌术后的必要性和临床应用价值。方法将2006年至2009年收治的124例胃癌患者按完全随机的方法分为留置鼻胃管组(60例)与无管组(64例),比较两组间肠道功能恢复情况、饮食情况、并发症的发生率及住院时间的情况。结果留置鼻胃管组的恶心发生率较高(63.3%vs.39.1%,P<0.05),但呕吐发生率两组无明显差异;无管组的患者可早期进食,进食流质时间(3.8±1.6)d和进食半流时间(5.1±1.9)d均明显短于对照组的(4.8±1.3)d和(7.2±2.2)d;肛门首次排气时间(2.6±0.8)d和首次排便时间(3.7±1.5)d均明显优于对照组的(3.8±1.6)d和(6.4±2.2)d。无管组患者住院时间明显短于对照组,分别为(10.1±4.1)d与(11.8±3.7)d。两组并发症的发生率并无明显差异。结论胃癌术后不常规留置鼻胃管安全、可行。无管组可缩短住院时间,患者康复快。

Objective To investigate the essentiality and value of nasogastric decompression in postoperative gastric cancer patients.Methods One hundred and twenty four consecutive gastric cancer patients enrolled from 2006 to 2009 were randomly divided into nasogastric tube group(n=60) and no-nasogastric tube group(n=64).Gastrointestinal function,diet time,postoperative complications as well as hospitalization time were compared between the two groups.Results The incidence of nausea was higher in nasogastric tube group(63.3%vs.39.1%,respectively),however there was no difference in the incidence of vomiting between the two groups.The postoperative time of eating fluid and semiflow diet were(3.8±1.6)d and(4.8±1.3)d in no-nasogastric tube group,significantly shorter than (5.1±1.9)d and(7.2±2.2)d in nasogastric tube group.The postoperative time of flatus and defecation were(2.6±0.8)d and(3.8±1.6)d in no-nasogastric tube group,both significantly shorter than(3.7±1.5)d and(6.4±2.2)d in nasogastric tube group.The hospitalization stay in no-nasogastric tube group was(10.1±4.11 )d,significantly shorter than(11.8±3.7)d in nasogastric tube group.There was no difference in the incidence of postoperative complications between the two groups.Conclusion Postoperative care without nasogastric tube decompression is safe and feasible in gastric cancer patients,which can improve recovery and shorten hospital stay.