结直肠癌手术中不置胃管的临床意义  

Disuse of gastric drainage and early initiation of diet for radical resections of colorectal cancer

作　　者：李显蓉[1] 杨庆强[1] 修鹏[2] 

机构地区：[1]泸州医学院附属医院普外科,四川泸州646000 [2]泸州医学院附属医院脊柱外科,四川泸州646000

出　　处：《重庆医学》2012年第22期2245-2246,共2页Chongqing medicine

基　　金：四川省卫生厅科研课题基金资助项目(110364)

摘　　要：目的探讨应用快速康复外科(FTS)理念,在结直肠癌根治术术前不留置胃管及术后早期进食的安全性及可行性。方法对该院胃肠外科进入快速康复的结直肠癌手术患者115例,按术前是否常规安置胃管分为观察组(55例)及对照组(60例),比较两组患者吻合口瘘、肺部感染的发生率以及恶心呕吐、咽喉疼痛、肛门排气时间及术后住院时间。结果所有患者均成功完成手术,两组患者在吻合口瘘发生率及住院时间等指标方面比较差异无统计学意义(P>0.05),观察组肛门排气时间缩短、咽喉疼痛、恶心呕吐及肺部感染的发生率明显低于对照组,差异有统计学意义(P<0.05)。结论应用FTS的理念,对结直肠癌根治术患者不留置胃管及术后早期进食是安全可行的,可以减少患者不适感并有利于患者早日康复。Objective To evaluate the safety and feasibility of disuse of gastric drainage and early initiation of diet for the perioperative management of patients receiving radical resection of colorectal cancer.Methods 115 patients with colorectal cancer were included in our department to receive the fast tract surgery program.They were subdivided into 2 groups.55 patients without use of gastric drainage were included in observed group,whereas the other 60 patients receiving gastric drainage were in controlled group.The incidence of anastomosis leakage,postoperative pneumonia,nausea and vomiting,and the anal exhaust time and duration of hospital stay were evaluated and compared between the 2 groups.Results All patients in the 2 groups were successfully managed with radical surgery.The incidences of anastomosis leakage and time of hospital stay were not significantly different between 2 groups.Compared with the controlled group,the patients in the observed group developed less nausea,vomiting,sore throat and postoperative pneumonia,and got anal exhausting earlier.The differences were statistically significant（P〈0.05）.Conclusion Disuse of gastric drainage and early initiation of diet is safe and feasible for the perioperative management of patients receiving radical resections of colorectal cancer.It will reduce the discomfort of patients and facilitate an early rehabilitation after surgery.

关 键 词：快速康复外科 留置胃管 术后早期进食 结直肠癌 

分 类 号：R735.3[医药卫生—肿瘤]