胆肠吻合术后早期进食与传统进食的临床疗效对比

Clinical effects of early postoperative oral feeding versus traditional oral feeding after bilioenteric anastomosis

目的:探讨胆肠吻合术后患者早期经口进食的安全性及有效性.方法:随机选取昆明医科大学第一附属医院我科2010-01/2012-12行胆肠吻合手术的78例病例,随机分为早期经口进食组(early oralfeeding,EOF)42例和传统进食组(traditionaloral feeding,TOF)36例,比较两组术后住院时间、首次排气和排便时间、营养情况以及并发症的发生率.结果:EOF组与TOF对照组比较,EOF组患者术后住院时间明显缩短、术后首次排气和排便时间均短于TOF组(P<0.05).在术后第3和第7天,EOF组患者白蛋白、前白蛋白、淋巴细胞计数均明显高于TOF组(P<0.05),两组术后并发症发生率的差异无统计学意义(P>0.05).结论:胆肠吻合术后EOF是安全可行的,患者术后胃肠道功能恢复明显加快,显著缩短了术后住院时间,但并发症发生率无明显增加.

AIM： To explore the security and feasibility of early postoperative oral feeding in patients after bilioenteric anastomosis. METHODS： A randomized controlled trial was performed on 78 patients who underwentbilioenteric anastomosis from January 2010 to December 2012 at the First Affiliated Hospital of Kunming Medical University. The patients were randomized into two groups： early oral feeding （EOF group, n = 42） and traditional oral feeding （TOF group, n =36）. The length of postoperative hospital stay, time to first flatus and defecation, nutritional status and postoperative complica- tions were compared. RESULTS： The EOF group was associated with significantly shorter post-operative hospital stay, time to first flatus and defecation compared with the TOF group （P 〈 0.05 for all）. The levels of al- bumin, prealbumin and lymphocyte count were significantly higher in the EOF group than in the TOF group on postoperative days 3 and 7 （P 〈 0.05 for all）. There were no significant differ- ences in patient characteristics and other postop- erative complications between the two groups （P 〉 0.05 for all）. CONCLUSION： Early oral feeding after bilio- enteric anastomosis is safe and beneficial, and leads to faster recovery of bowel function and shorter postoperative hospital stay without in- creasing postoperative complications.