远端胃癌根治术后不置胃管及早饮水的可行性和安全性研究

Feasibility and safety study of no setting gastric tube and early drinking water for post-operative patients with distal gastric cancer radical gastrectomy

目的：探讨远端胃癌根治术后不置胃管及早饮水的安全性和可行性。方法将100例行远端胃癌根治术的患者根据手术先后顺序随机分为对照组和观察组各50例。对照组采用外科术后护理常规，予以安置胃管，禁食、禁饮，保留胃管至肛门排气、排便后再进食水；观察组除外科护理常规外，不安置胃管，术后6h患者麻醉完全清醒后，在医生指导下协助患者每4h饮一次温开水，每次10～20ml，对两组患者术后肠功能恢复时间、下床活动时间、腹胀、呼吸道感染、吻合口瘘等因素进行分析。结果观察组术后肠功能恢复时间短、下床时间早，差异具有显著意义（P＜0．05）；观察组术后咽喉疼痛、肺部感染发生率低，两组差异具有显著意义（P＜0．05）；两组术后恶心呕吐、吻合口瘘、腹胀发生的差异无显著意义（P＞0．05）。结论远端胃癌根治术后不置胃管及早饮水是安全可行的，可促进肠功能的恢复及减少术后并发症，提高患者舒适度，有利于病人术后的恢复。

Objective To study the feasibility and safety of no setting gastric tube and early drinking water for post-operative patients with distal gastric cancer radical gastrectomy .Method 100 post-operative patients with distal gastric cancer radical gastrectomy was randomly divided into control group and observation group according to the operation order ,50 patients in the control group received routine postoperative care ,placed stomach ,fasting , drinking and keeping the stomach exhaust pipe to the anus after defecation eating water .Patients in observation group received routine nursing ,did not place the tube ,but did drinking warm water 10~20 ml for every four hours under the guidance of doctors 6 hours after the patient fully awake from anesthesia ,The post-operative intestinal function recovery time ,ambulation ,bloating ,respiratory infections ,anastomotic leakage and other factors were ob-served and analyzed between two groups .Result The post-operative intestinal function recovery time and bed time in observation group was shorter .There was significant difference compared with control group （P＆lt;0 .05）;The inci-dence of lung infection and post-operative sore throat in observation group was lower than that of control group . There was significant different （P＆lt;0 .05）;The incidence of post-operative nausea and vomiting ,anastomotic leak-age ,bloating occurred was significant difference between the two group （P＆gt;0 .05） .Conclusion No setting gastric tube and early drinking water for post-operative patients with distal gastric cancer radical gastrectomy was feasible and safe ..It can promote the recovery of bowel function ,postoperative rehabilitation and reduce postoperative com-plications .