早期拔除胃管并早期进食对结直肠癌手术患者术后恢复的影响

Effect of early extubation and early diet on postoperative recovery of patients with colorectal cancer surgery

目的研究早期拔除胃管并早期进食对结直肠癌病人术后恢复的影响。方法将120例择期结直肠手术患者，随机分为对照组和观察组，每组各60例。对照组按照常规于患者肛门排气后拔除胃管并进食流质，观察组则于术后第1天拔除胃管并早期恢复流质饮食。观察比较两组患者术后恢复情况、并发症的发生情况及患者的舒适度。结果观察组的肛门排气时间缩短、首次下床活动时间提早（P〈0．01），72h腹胀减轻（P〈0．05），与对照组相比，差异有统计学意义；两组切口裂开／感染、吻合口瘘发生情况比较，差异无统计学意义（P〉0．05）；而恶心呕吐、咽喉部疼痛、咳嗽、咳痰、肺部并发症的情况比较，差异有统计学意义（P〈0．01）；两组舒适度比较，差异有统计学意义（P〈0．01）。结论留置胃管不能减少术后切口裂开、吻合口瘘的发生，相反与留置胃管直接有关的并发症如：恶心呕吐、咽喉部疼痛、咳嗽、咳痰、肺部并发症等却发生较多。而早期拔除胃管并早期进食，能促进肠功能恢复，减轻患者的痛苦。

Objective To explore the effect of early extubation and early diet on postoperative recovery of pa- tients with colorectal cancer surgery. Methods 120 cases of selective colorectal operation patients were randomly divid- ed into control group and observation group, 60 cases in each group. Patients in the control group were treated with extu- bation and fluidity after anal exsufflation, in the observation group were treated with early fluidity diet at postoperative 1 day extubation. Postoperative recovery, complications and patient comfort were observed and compared between the two groups. Results Compared with control group, anal exhaust time shortened, the first ambulation time was in advance （P〈0. 01 ） 72 h distension weaken （P〈0. 05 ）, there were significant differences between the two groups. There were no significant differences in incision dehiscence/infection, anastomotic leakage between the two groups （P〉0. 05） . There were significant differences in nausea and vomiting, throat pain, cough expectoration, pulmonary complications between the two groups （P〈0. 01 ） . There was significant difference in degree of comfort between the two groups （P〈 0. 01 ） . Conclusions Indwelling gastric tube can reduce postoperative wound dehiscence, anastomotic leakage, in contrast with indwelling gastric tube directly related complications such as： nausea and vomiting, throat pain, cough, expectoration, pulmonary complications are more frequent. Early covery of intestinal function and reduce the oain of patients. extubation and early oral feeding can promote the re-