食管癌根治术后不留置胃肠减压管对患者的影响

Effect of No Gastrointestinal Decompression Tube on Postoperative Patients with Esophageal Cancer

目的探讨食管癌根治术患者术后不留置胃肠减压管的可行性及其对蛋白水平的影响。方法按照随机数字表法将鹤壁市人民医院2020年10月至2022年3月收治的93例食管癌根治术后患者分为观察组47例和对照组46例。对照组术后常规留置胃肠减压管,观察组术后不留置胃肠减压管,对比两组患者胃肠功能恢复情况、营养状况以及并发症发生率。结果术后,观察组首次肠鸣音、肛门排气、排便、开始进食以及住院时间均明显短于对照组(P<0.05)。术前,两组患者血清前白蛋白(prealbumin,PA)、血清运铁蛋白(transferrin,TF)以及血清白蛋白(ALB)、腹围无明显差异(P>0.05),术后1 d两组PA、TF、ALB水平均下降但观察组高于对照组,术后7 d,两组PA、TF、ALB水平均明显上升,且观察组明显高于对照组(P<0.05);术后不同时间段观察组腹围均明显大于对照组(P<0.05);观察组咽喉肿痛(34.04%)、吻合口瘘(2.13%)、肺感染(4.26%)、呕吐(31.91%)、声音嘶哑(10.64%)、腹胀(17.02%)的发生率和对照组(分别为47.83%、6.53%、8.69%、41.30%、13.04%、26.09%)组对比差异无统计学意义。结论食管癌根治术后不留置胃肠减压管可缩短首次肠鸣音、肛门排气、排便、开始进食以及住院时间,改善营养状况,促进腹围恢复且不增加不良反应的发生率。

Objective To investigate the feasibility of no indwelling gastrointestinal decompression tube after radical resection of esophageal cancer and its impact on protein level.Methods 93 postoperative patients with esophageal cancer admitted to our hospital from October 2020 to March 2022 were divided randomly into an observation group(47)and a control group(46).The control group received routine indwelling of a gastrointestinal decompression tube after surgery,while the observation group received no indwelling of astrointestinal decompression tube after surgery.The recovery of gastrointestinal function,nutritional status,and incidence of complications were compared between 2 groups.Results After surgery,the observation group had significantly shorter initial bowel sounds,anal discharge,defecation,onset of eating,and hospital stay than the control group(P<0.05).Before surgery,there was no significant difference in serum prealbumin,serum transferrin,serum albumin,and abdominal circumference between 2 groups(P>0.05).On the 1st day after surgery,the levels of PA,TF,and ALB in both groups decreased,but it was higher in observation group than that in control group.On the 7th day after surgery,the levels of PA,TF,and ALB in both groups increased significantly,and they were significantly higher in observation group than those in control group(P<0.05).The abdominal circumference of the observation group was significantly higher than that of the control group at different time periods after surgery(P<0.05).The incidence of throat swelling and pain(34.04%),anastomotic fistula(2.13%),lung infection(4.26%),vomiting(31.91%),hoarseness(10.64%),and abdominal distension(17.02%)in the observation group was not statistically significant compared to the control group(47.83%,6.53%,8.69%,41.30%,13.04%,26.09%,respectively).Conclusion After radical resection of esophageal cancer,no indwelling gastrointestinal decompression tube can shorten the first bowel sound,anal exhaust,defecation,start eating,and hospitalization time,improve nutritional status,promote abdominal circumference recovery,and do not increase the incidence of adverse reactions.