胃肠减压在下消化道切除吻合术后应用的必要性评价

Evaluation of clinical necessity of gastrointestinal decompression after excision and anastomosis of lower digestive tract

目的评价术后应用胃肠减压在下消化道手术中的必要性。方法将368例下消化道切除吻合术患者随机分为术后胃肠减压组与术后无胃肠减压组,比较两组的临床治疗效果及并发症发生情况。结果减压组术后每天胃液量10～520ml,第1天低于术后第2、3天。术前、术后平均腹围两组间差异无统计学意义(P>0.05),但两组术前腹围均小于术后(P<0.001)。两组肛门排气排便时间差异无统计学意义(P>0.05)。减压组并发症发生率(28.0%)明显高于无减压组(8.2%),P<0.001,其中咽喉炎发病率达23.1%。术后平均住院天数两组间差异无统计学意义(P>0.05)。结论下消化道切除吻合手术后不置胃肠减压更有利于患者的恢复。

Objective To evaluate the clinical necessity of postoperative ga st rointestinal decompression after operation on lower digestive tract. Methods Thr ee hundred and sixty eight patients who required excision and anastomosis of lo wer digestive tract were randomly divided into two groups,with or without receiv ing gastrointestinal decompression after operation. Clinical therapeutic efficac y and complications were compared between two groups. Results The volume of gast rointestinal suction ranged from 10 ml to 520 ml each day after operation,and wa s less on the first day than those on the second and the third day after operati on in decompression group. There was no significant difference in the average gi rth between two groups before and after operation. The average girths were short er before operation than those after operation in two groups(P< 0.001). There was no significant difference in postoperative defecation and urination time bet ween two groups(P >0.05). The complication rate was significantly higher in deco mpression group than that in non decompression group (28%vs. 8.2%,P< 0.001). The incidence of pharyngolaryngitis was up to 23.1%in decompression group. Ther e was no difference in hospital stay between the two groups after operation. Con clusion The recovery of patients who receive excision and anastomosis of lower d igestive tract will benefit from non gastrointestinal decompression.