胃肠减压对胃癌患者远端胃切除术围手术期效果的影响  

Effect of Gastric Decompression on Short-term Outcome of Patients Receiving Distal Gastrectomy

作　　者：蔡磊[1] 连肖[1] 李艳 郭曼[1] 杨学文[1] 王文斌[1] 洪流[1] 

机构地区：[1]第四军医大学西京消化病医院,陕西西安710032 [2]西北妇女儿童医院麻醉科,陕西西安710061

出　　处：《现代生物医学进展》2015年第32期6251-6254,共4页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81300301);第四军医大学优秀文职人员培养基金项目;第四军医大学西京医院2014年度助推计划

摘　　要：目的:探讨胃癌患者远端胃大部切除术后放置鼻胃管引流的短期效果。方法:选取我科从2010年9月1日到2013年3月1日间318例胃癌行远端胃切除的患者,随机分为术后留置鼻胃管(NGT组)或不留置组(no NGT组),比较两组间围手术期的短期效果。结果:158例患者纳入NGT组,而160例患者纳入no NGT组。两组间在术后腹胀、持续呕吐、吻合口瘘、发热、肺部感染、伤口感染的发生率上无统计学差异(P>0.05)。进一步分析65例既往有腹部手术史的患者(NGT组34例vs no NGT组31例),NGT组腹胀发生率(5.88%vs 29.03%,P<0.05)显著低于no NGT组。结论:对于胃癌患者行远端胃切除术后不推荐放置鼻胃管;而对于既往有腹部手术史的患者,术后放置胃管可以降低腹胀的发生。Objective： To evaluate the effect of nasogastric drainage on perioperative period short-term outcome of gastric cancer patients after distal gastrectomy. Methods： 318 patients with gastric cancer were enrolled as objects from September 2010 to March 2013. Patients were randomly assigned to receive either gastric decompression （NGT group） or not （no NGT group） after the distal gastrectomy. Details concerning the demographic data and perioperative period outcomes were collected and analyzed. Results： Totally 158 patients were involved in the NGT group and 160 in the no NGT group. Among them, 65 patients with the history of abdominal operation were involved, including 34 in NGT group and 31 in no NGT group. In the whole, there were no significant differences between the two groups with respect to demographic data, the rate of abdominal distension, persistent vomiting, anastomotic leak, fever, pulmonary infection and wound infection. Among the patients with history of abdominal operation, the rate of abdominal distension （5.88 % vs 29.03 %, P〈0.05） in NGT group was significantly less than that of no NGT group. Conclusions： Gastric decompression is not recommended for patients with gastric cancer receiving distal gastrectomy, but it is suitable for the patients with history of abdominal operation.

关 键 词：胃肠减压 胃癌 远端胃切除术 

分 类 号：R735.2[医药卫生—肿瘤]