胃肠减压在不同方式胃切除术后的应用效果

Application of gastrointestinal decompression after different types of surgical gastrectomy

目的探讨胃肠减压在不同方式胃切除手术后的应用效果。方法选取海丰县彭湃纪念医院行不同方式胃切除手术后进行胃肠减压的100例患者作为研究对象,其中胃大部切除胃十二指肠吻合术45例,胃大部切除胃空肠吻合术19例,胃近端大部切除15例,全胃切除21例,分析患者行不同手术方式术后胃液引流量、肛门排气时间、留置胃管时间、术后恶心呕吐、腹胀情况。结果不同术式胃切除手术后胃肠减压引流胃液量、术后腹胀、留置胃管时间差异均有统计学意义(P<0.05);术后患者的恶心呕吐程度、肛门排气时间差异均无统计学意义(P>0.05)。结论不同手术方式胃切除术后行胃肠减压应选择高危病例作为减压对象,并且在留置胃管的时间上要合适,以减少或避免术后不适或并发症的发生。

Objective To investigate the effect of gastrointestinal decompression on different surgical gastrectomy. Methods One hundred patients underwent gastrointestinal decompression after different surgical gastrectomy were selected, and were divided into four groups according to the different method of gastrectomy. Group A ： 45 cases of subtotal gastric resection ＋ gastroduodenostomy; group B： 19 cases of subtotal gastric resection ＋ gastrojejunostomy; group C： 15 cases of proximal gastrec- tomy; group D： 21 cases of total gastrectomy. The gastric drainage volume, anus exhausting time, gastric tube detaining time, postoperative nausea and vomiting, abdominal distension was analyzed. Results The differences of gastric drainage volume, ab- dominal distention and gastric tube detaining time were statistically significant among the four groups （P 〈 0. 05 ） ; but the degree of postoperative nausea and vomiting, anus exhausting time had no statistically significant differences among the four groups（ P 〉 0. 05 ）. Conclusion Application of gastrointestinal decompression after different surgical gastrectomy should be selected the high-risk cases as the relief object, and in the timing of indwelling stomach tube to the right, in order to reduce or avoid the oc- currence of postoperative discomfort and complications.