胃肿瘤手术病人术前口服糖水临床研究

Clinical study on preoperative oral carbohydrate for patients performed gastric neoplasms resection

目的探讨术前口服糖水用于胃肿瘤手术的安全性和有效性。方法选择2012年1-5月四川大学华西医院胃肠外科中心收治的44例胃肿瘤病人作为干预组(术前口服糖水);另以性别、年龄、手术切除方式为基线指标,按照1∶2比例进行配对,从2011年6月至2012年6月同一中心收治的胃肿瘤病人中选取88例作为对照组(常规术前准备)。比较两组病人术中、术后情况。结果干预组手术时间、术中出血量与对照组差异无统计学意义(P>0.05),两组均无反流误吸发生。两组在胃管拔出时间、胃管引流总量、尿管拔出时间、腹腔引流管拔出时间、肛门排气时间、开始进食流质时间、手术并发症发生率、非手术并发症发生率以及住院时间方面差异均无统计学意义(P>0.05)。干预组病人腹腔引流总量低于对照组[(197.3±118.8)m L vs.(269.2±207.3)m L,P=0.019]。两组病人术后均无30 d内再入院者。结论胃肿瘤手术病人术前口服糖水较安全,但与常规术前准备相比,其在病人术后早期康复以及减少术后住院时间方面优势并不明显。

Objective To investigate the safety and efficacy of oral intake of glucose solution before surgery in patients performed resection for gastric neoplasms. Methods The clinical data of 44 patients who underwent resection for gastric neoplasms between January 2012 and May 2012 in the Department of Gastrointestinal Surgery, West China Hospital of Sichuan University were collected. The 44 patients with preoperative oral carbohydrate were assigned to group A,while the other 88 patients （group B） with fasting for 10 hours before operation were matched with those in group A with the ratio of 2 ： 1 by gender, age and type of gastrectomy. The comparison was based on the operative and postoperative measures. Results The operation time and the blood loss did not differ between the two groups, while no regurgitation and pulmonary aspiration of gastric contents occurred in both groups. There was no significant difference in the time to pull gastric tube, catheter and abdominal drain tube, the amount of gastric tube drainage liquids, time to first flatus, tittle of resume fluids, incidence of operative and nonoperative complication, time of hospital stay between two groups （P〉0.05）. Compared to group B, the amount of abdominal drain drainage liquids in group A was smaller（ 197.3±118.8 mL vs. 269.2±207.3 mL, P=0,019）. Furthermore, No hospital readmission was found in 30 days after operation in two groups. Conclusion The safety of administering preoperative oral carbohydrate fluids is supported. But the benefit of the treatment regimen for contributing to improve early rehabilitation and shorter hospital stays after elective gastric surgery is not superior to traditional preoperative preparation.