肝癌择期切除术行胃肠减压的临床随机对照研究

Is Routine Nasogastric Decompression after Selective Hepatectomy for Hepatocellular Carcinoma Necessary:a Prospective Randomized Control Trail

目的:评价肝癌择期行肝切除术是否需要常规胃肠减压。方法:将2008年1月到2011年10月择期行肝切除术的肝癌患者380例随机分为胃肠减压组和无胃肠减压组各190例,比较两组术后并发症、死亡率及住院时间等。结果:所有患者术中均无严重的并发症和死亡。无胃肠减压组1例于术中放置鼻胃管,术后即拔除,两组均无术后需置鼻胃管病例。两组患者术后在肛门排气时间、恶心、呕吐、手术并发症、住院时间等方面无明显差异(P>0.05)。结论:肝癌择期行肝切除术无需常规胃肠减压,常规胃肠减压既不能减少术后并发症和死亡率,也不能缩短胃肠功能恢复时间和住院时间。

Objective： To evaluate if routine nasogastric tube （NGT） decompression after selective hepatectomy for hepatocellular carcinoma （HCC） is necessary. Methods： 380 patients with HCC treated with selective hepatectomy were included and randomized into routine NGT group （n=190） and no NGT group （n=190） from Jan 2008 to Oct 2011. Postoperative complications, mortality, hospital stay et al. were analyzed and compared between the two groups. Results： All cases were treated with selective hepatectomy without serious complication and mortality. One case in no NGT group need NGT insertion during operation and removed after operation, no case need NGT insertion in two groups after operation. The terms of postoperative time to pass flatus, nausea, vomiting, operative complications and hospital stay were no significant difference between the two groups, all P〉0.05. Conclusion： Routine NGT decompression after elective hepatectomy for HCC is unnecessary. Routine NGT decompression don＇t reduce postoperative complications and mortality, nor shorten time to pass flatus and hospital stay.