快速康复外科胃肠道手术不置胃肠减压管并早期进食的护理研究

The outcomes of early oral feeding without nasogastric decompression tube in patients after abdominal fast-track surgery

目的探讨快速康复外科胃肠道手术后,不留置胃肠减压管并早期进食的安全性及可行性。方法以2008年1-6月行胃肠道手术的58例患者为观察组,不留置胃肠减压管并早期恢复进食。以2006年11月至2007年12月的62例胃肠道手术患者为对照组,术中放置胃肠减压管直至恢复肛门排气。比较两组病例术后肛门恢复排气时间、咽喉疼痛、恶心、鼻咽部不适、急性胃扩张、切口感染、肺部感染、吻合口瘘等术后并发症发生率。结果与对照组相比,观察组肛门恢复排气时间提前,差异有统计学意义(P<0.05),两组患者急性胃扩张、切口感染、肺部感染、吻合口瘘等并发症的发生率方面,差异无统计学意义(P>0.05),对照组患者诉咽喉疼痛、恶心呕吐、胃部不适明显较观察组增多(P<0.01)。结论胃肠手术后不放置胃肠减压管并早期恢复进食安全可行,有利于患者的快速康复。

Objective To explore the safety and feasibility of early oral feeding without nasogastric decompression tube in patients after fast-track gastrointestinal surgery. Methods The 58 patients with early oral feeding without nasogastric decompression tube from January 2008 throught June 2008 were recruited as the experimental group ,while the 62 patients with nasogastric tube from November 2006 threught December 2007 were selected as control group. The time to first passage of flatus and incidences of postoperative complications such as pharyngalgia,nausea,nasopharyngeal discomfort,acute gastric distension, surgical wound infection,pulmonary infection,and anastomotic fistulae were recorded and compared between the two groups. Results The time to first passage of flatus was significantly shorter in the experimental group than that of control group （P〈 0.05）. There were no significant differences in the incidences of acute gastric distension,surgical site infection,pulmonary infection and anastomotic fistulae between the two groups （P〉0.05）. The incidences of pharyngalgia,nansea and vomiting,and stomach discomfort in the experimental group were significantly lower than that of control group （P〈0.01）. Conclusion Early oral feeding without nasogastric decompression tube is proved to be safe and feasible in patients after fast-track gastrointestinal surgery.