妇科恶性肿瘤患者经腹手术后早进食的研究

Study on early oral intake after intraabdominal gynecologic oncology surgery

目的 探讨妇科恶性肿瘤患者经腹手术后6h即给予半流质饮食的安全性和临床意义。方法 以60例经腹手术的妇科恶性肿瘤患者为研究对象，随机分成实验组30例和对照组30例，实验组术后6h即给予半流质饮食，而对照组则采用传统方法术后6h进流食，在肛门排气后方改为半流食，比较2组患者术后恶心、呕吐发生情况，肠蠕动恢复时间、肛门排气时间、固体饮食恢复时间、体质量差、血糖、尿酮体、血清前白蛋白变化隋况、伤口愈合情况及肠梗阻发生情况。结果 2组患者无一例发生窒息或吸人性肺炎；无一例出现肠梗阻而需胃肠减压；实验组患者术后6h进半流质饮食后恶心的发生率明显高于对照组（χ^2=5．51，P〈0．05），固体饮食恢复时间较对照组提早近18h（t=4．11，P〈0．05），第7天血清前白蛋白值显著高于对照组（t=3．60，P〈0．05），而在呕吐、尿酮体、肠蠕动恢复时间、排气时间、手术前后体质量差和术后第2天血清前白蛋白值等方面差异无统计学意义（P〉0．05）。结论 妇科恶性肿瘤患者经腹手术后6h给予半流质饮食是安全的，而且有助于提早恢复固体饮食，改善患者营养状况，促进术后康复。

Objective To explore the safety and efficacy of a semiliquid diet 6 hours later after major abdominal gynecologic oncology surgery. Methods 60 gynecology oncology patients undergoing major intra-abdominal surgery were enrolled in a randomized clinical trial of a semiliquid diet （experimental group, 30 cases ） compared with clear feeds 6 hours later after surgery （ controlled group, 30 cases）. Patients were evaluated for nausea, vomiting, bowel sound, flatus, body weight, urine acetone, blood glucose and pre-albumin level, and need for nasogastric decompression. Results There were statistically higher incidence of nausea （χ^2=5.51 ,P 〈 0.05）, shorter time of regular diet resumption（t= 4.11, P 〈 0.05）and higher level of pre-albumin on the 7th postoperative day （t= 3.60, P 〈 0.05）in the experimental group.No significant difference was found in vomiting, the time to development of bowel sound and passage of flatus, body weight, urine acetone, blood glucose, pre-albumin level on the 2nd postoperative day in two groups. Conclusion Early oral intake with semiliquild diet 6 hours later after major intraabdominal gynecologic oncology surgery is safe and well-tolerated.