加速康复外科理念下胃肠道手术放置引流管的争议与对策

Controversy and countermeasures of placement of drainage tube in gastrointestinal surgery under the concept of enhanced recovery after surgery

外科引流在胃肠外科疾病的诊治过程中起着十分重要的作用,特别是在腹腔感染、消化道漏或重症胰腺炎等治疗中是必不可少的治疗措施。加速康复外科理念在国内外已经实践多年,是否放置引流管在胃肠道手术的ERAS临床实践中一直争议不断。本文就外科引流的定义及其分类、引流的目的、适应症、引流物的选择、在ERAS理念下胃肠道手术常见放置引流管(包括鼻胃管、尿管、腹腔或盆腔引流管、肛管引流管)的争议与对策等相关问题做一深入探讨。

Surgical drainage plays a very important role in the process of diagnosis and treatment with the diseases of gas鄄trointestinal surgery,particularly in the treatment of abdominal cavity infection,gastrointestinal fistula,or severe acute pancreatitis.It is an essential treatment measures.Enhanced Recovery After Surgery has already been practiced for many years at home and abroad.There has been controversy over the placement of drainage tubes in ERAS clinical practice of gastrointestinal surgery.In this paper,the related to controversy and countermeasures of the definition and classification of surgical drainage,the purpose and indications of drainage,the choice of drainage tubes,the purpose of the common gastrointestinal surgery drainage tube placement in the concept of ERAS渊including nasogastric tube,urinary catheter,abdominal or pelvic drainage tube,anal canal drainage tube冤will be deeply discussed.