胃癌根治术后不常规留置胃肠减压管的安全性及有效性分析

Safety and effect of none routine nasogastric decompression tube after radical gastrectomy

目的探讨胃癌根治术后不常规留置胃肠减压管的安全性及有效性。方法回顾性分析第二军医大学长海医院胃肠外科2013年1月至2015年1月间收治的行胃癌根治术患者的临床病理资料,其中术后未常规留置胃肠减压管患者(A组)与术后常规留置胃肠减压管患者(B组)各纳入50例,比较两组患者的术后肛门排气时间、进食半流时间、住院时间及术后并发症等情况。结果 A组的术后平均进食半流时间[(5.82±1.10)d vs(7.80±1.92)d]及术后平均住院时间[(6.82±1.27)d vs(9.10±3.42)d]均较B组缩短(P<0.001),B组术后发生咽喉痛的患者明显多于A组(P<0.001),而恶心呕吐、吻合口瘘、吻合口出血、切口感染、腹胀、腹腔感染及二次手术等术后并发症的发生率在两组间的差异无统计学意义(P>0.05)。结论胃癌根治术后不常规留置胃肠减压管是安全的,并能加快患者术后的恢复,缩短住院时间。

Objective To investigate the safety and effect of none routine nasogastric decompression tube after radical gastrectomy. Methods The clinical data of 100 patients who underwent radical gastrectomy in our department from January 2013 to January 2015 were retrospectively analyzed. Among them, 50 patients did not receive postoperative nasogastric tube decompression （group A） and 50 patients received nasogastric tube decompression after operation （group B）. The time to flatus, semi-liquid diet, length of hospital stay and associated postoperative complications were compared between the two groups. Results The time to have semi-liquid diet （[5. 82±1. 10] d vs [ 7. 80±1. 92] d） and length of hospital stay （[6. 82±1. 27] d vs [9. 10±3. 42] d） in group A were significantly shorter than those in group B （P〈0. 001）. The incidence of pharyngalgia in group B was significantly higher than that in group A （P 〈 0. 001）; however, other postoperative complications such as vomiting and nausea, leakage of anastomosis, bleeding of anastamosis, infection of incision, abdominal distention, abdominal infection, or secondary operation were not significantly different between the two groups（P〉0. 05）. Conclusion None routine nasogastric decompression tube is safe for patients who have received radical gastrectomy, and it may accelerate postoperative recovery and shorten the hospital stay.