胃肠手术患者胃管不同处理方式对胃肠功能恢复的影响

Effect of different treatments of stomach tube on recovery of gastrointestinal function in patients with gastrointestinal surgery

目的探讨胃管不同处理方式对胃肠手术患者胃肠功能恢复效果的影响。方法回顾性分析2016年1月-2018年1月期间在商丘市第一人民医院接受胃肠手术治疗的100例患者的临床资料,依据胃管处理方式的不同,将上述入选者进一步划分为观察组(不留置胃管,53例)与对照组(留置胃管,在患者麻醉完全清醒后12 h拔出,47例),比较两组患者胃肠功能恢复效果[肠鸣音恢复时间、首次排便时间、首次排气时间]、胃动素、血管活性肠肽、胰高血糖素水平以及术后并发生发生情况。结果观察组患者肠鸣音恢复、首次排便以及首次排气时间均短于对照组患者,差异有统计学意义(t=3.933、2.094、2.205,P=0.000、0.039、0.030);术前,两组患者胃动素、血管活性肠肽以及胰高血糖素水平对比,差异无统计学意义(t=0.540、0.220、0.752,P=0.590、0.826、0.436);术后1 d,两组患者胃动素、血管活性肠肽以及胰高血糖素水平对比,差异无统计学意义(t=0.344、0.835、0.788,P=0.732、0.406、0.432);术后3 d,观察组患者胃动素水平高于对照组患者,血管活性肠肽水平低于对照组患者,胰高血糖素低于对照组患者,差异有统计学意义(t=10.883、5.144、14.732,P均=0.000);两组均未出现咽喉不适、肠梗阻情况,观察组患者并发症发生率为7.55%,对照组患者为14.89%,组间对比,差异无统计学意义(χ^2=1.373,P=0.241)。结论胃肠手术患者后采取胃管不留置方案可有效促进患者术后胃肠功能恢复,且对胃动素、血管活性肠肽以及胰高血糖素水平的影响较小,具有一定安全性以及临床推广与应用价值,利于患者接受。

Objective To investigate the effect of different treatments of stomach tube on recovery of gastrointestinal function in patients with gastrointestinal surgery.Methods The clinical data of 100 patients with gastrointestinal surgery in the hospital from January 2016 to January 2018 were retrospectively analyzed.All selected cases were divided into observation group(no stomach tube indwelling,53 cases)and control group(stomach tube indwelling,and it was pulled out after the anesthesia completely awakening for 12 h,47 cases)by different treatments of stomach tube.The recovery of gastrointestinal function[recovery time of bowel sound,first defecation time,first exhaust time],motilin,vasoactive intestinal peptide,glucagon and postoperative complications were compared between the two groups of patients.Results The recovery time of bowel sound,first defecation time and first exhaust time in observation group were shorter than those in control group,and the difference was statistically significant(t=3.933,2.094,2.205,P=0.000,0.039,0.030);There was no statistical difference in the levels of motilin,vasoactive intestinal peptide and glucagon between the two groups before surgery(t=0.540,0.220,0.752,P=0.590,0.826,0.436);After surgery for 1 d,there was no statistical difference in the levels of motilin,vasoactive intestinal peptide and glucagon between the two groups(t=0.344,0.835,0.788,P=0.732,0.406,0.432);The postoperative 3 d motilin of observation group was higher than that of control group,the vasoactive intestinal peptide in observation group was lower than that in control group,and the glucagon in observation group was lower than that in control group(t=10.883,5.144,14.732,P=0.000);There were no throat discomfort and intestinal obstruction in two groups,and there was no statistical difference in the incidence of complications between observation group(7.55%)and control group(14.89%)(χ^2=1.373,P=0.241).Conclusion The patients with gastrointestinal surgery but without stomach tube indwelling can effectively promote recovery of postoperative gastrointestinal function,and have little effect on motilin,vasoactive intestinal peptide and glucagon,have certain safety and clinical value of promotion and application,which is easily accepted by the patients.