胆肠吻合术后早期拔除胃管对提高患者舒适度效果观察

Early nasogastric tube extubation enhances patients’ comfort after cholangiojejunostomy

目的:探讨胆肠吻合术后早期拔除胃管对患者舒适度的影响。方法:将40例择期行胆肠吻合术患者随机分成早期拔管组和常规拔管组,每组各20例。早期拔管组于术后12h内拔除胃管,术后24h开始进食流质,常规拔管组于肛门自主排气后拔除胃管并进食流质。比较两组患者的舒适度、并发症、肛门自主排气时间、初次下床活动时间、住院时间。结果:早期拔管组患者的舒适度优于常规拔管组,差异有统计学意义(P<0.05)。早期拔管组恶心、呕吐、咳嗽、咳痰、咽部疼痛、肺部感染及肺不张发生率明显低于常规拔管组,差异有统计学意义(P<0.05)。两组腹胀及切口感染发生率比较,差异无统计学意义(P>0.05)。早期拔管组患者肛门自主排气时间、初次下床活动时间更早,住院时间更短,差异有统计学意义(P<0.05)。结论:胆肠吻合术后早期拔除胃管可提高患者舒适度,有利于患者康复,值得临床借鉴。

Objective:To explore the influence of patients' comfort by early nasogastric tube extubation after cholangiojejunostomy.Methods:40 patients undergoing elective cholangiojejunostomy were randomly divided into two groups (early extubation group and routine extubation group, n =20).In the early extubation group,the nasogastric tube was removed within 12 h and fed liquids within 24 h after operation,while in the routine extubation group,the nasogastric tube was removed after anus exhaust.The comfort,complications,time of anus exhaust,time of first ambulation and time of hospitalization were compared between the two groups.Results:The comfort level of patients in the early extubation group was better than that in the conventional extubation group ( P <0.05).The incidence of nausea,vomiting,cough,expectoration,pharyngeal pain,lung infection and pulmonary atelectasis in the early extubation group were significantly lower than those in the conventional extubation group ( P <0.05).However,there was no significant difference in the incidence of abdominal distension and incision infection ( P >0.05 ).In the early extubation group,the time of anus exhaust,the time of first ambulation were earlier,and the time of hospitalization was shorter( P <0.05).Conclusion:Early removal of nasogastric tube after cholangiojejunostomy can improve the comfort of patients and benefit their recovery,which is worthy of clinical reference.