早期进食对右半结肠切除术患者肠功能的影响  

Effect of early feeding on intestinal function in patients undergoing right hemicolectomy

作　　者：黎少芳[1] 路海云[1] 李燕如[1] 聂凤妹[1] 严业华 LI Shaofang;LU Haiyun;LI Yanru;NIE Fengmei;YAN Yehua(Department of Gastrointestinal Surgery,the Second People′s Hospital of Foshan City,Foshan,Guangdong 528000,China)

机构地区：[1]广东省佛山市第二人民医院胃肠外科,528000

出　　处：《重庆医学》2020年第8期1336-1339,共4页Chongqing medicine

基　　金：广东省佛山市自筹经费类科技计划项目(2017AB001721)。

摘　　要：目的探讨术后6 h开始经口流质饮食对右半结肠切除术患者肠功能的影响。方法选择2018年5月至2019年1月该院收治的升结肠癌及横结肠癌术后患者60例,采用单盲随机法分为观察组30例及对照组30例,观察组患者术前不留置鼻胃管或术毕即拔除鼻胃管,在术后6 h麻醉清醒,生命体征及病情稳定后开始进食流质,每次20 mL,间隔2 h进食1次,术后第2天开始少量多餐进食半流质饮食,每次100~150 mL,间隔2~3 h进食1次,直至过渡到普通饮食,患者在术后3~4 d停止输液,完全经口进食;对照组患者在术后采用传统围术期护理,术前常规留置胃管,在患者恢复肠鸣音3~5次/min,有肛门排气后再拔除胃管,开始进食温开水、流质饮食每次20 mL,间隔2 h进食1次,进食流质2 d后开始少量多餐进食半流质饮食,每次100~150 mL,间隔2~3 h进食1次,直至过渡到普通饮食。结果观察组胃肠功能恢复时间明显比对照组缩短(P<0.05);观察组术后1、3、5 d血清清蛋白水平较术前有所降低(P>0.05),但略高于对照组(P<0.05)。观察组患者无肠梗阻、吻合口瘘的发生,只有术后恶心、呕吐,腹胀各发生1例,对照组患者发生2例吻合口瘘、4例肠梗阻及8例术后腹胀,观察组明显优于对照组(P<0.05)。结论早期经口进食安全、方便,能明显促进胃肠功能恢复,防止并发症发生,促进患者术后康复。Objective To investigate the effect of oral liquid diet starting at postoperative 6 h on intestinal function in the patients undergoing right hemicolectomy.Methods Sixty postoperaive patients with ascending and transverse colon cancer treated in this hospital from May 2018 to January 2019 were selected and divided into the observation group(n=30)and control group(n=30)by adopting the single blind random method.The patients in the observation group did not indwell the nasogastric tube before operation or the nasogastric tube was removed immediately after operation.After the postoperative anesthesia waking up at postoperative 6 h,the vital signs and disease condition were stable,the fluid diet began,20 mL each time,once at intervals of 2 h,the semi-liquid diet with small amount of multi-meals began on postoperative 2 d,100-150 mL each time,once at intervals of 2-3 h,until the transition to normal diet,the patients stopped the solution transfusion on postoperative 3-4 d,completely conducted oral eating;the patients in the control group adopted the traditional perioperative nursing care after operation.The stomach tube was routinely indwelled before operation.The patients recovered the bowel sound for 3-5 times per min.The stomach tube was removed after anal exhausting,the patients began to take warm water and fluid diet,20 mL per time,once at intervals of 2 h,started to take small amount of multi-meal semi-liquid diet on 2 d after eating fluid diet,100-150 mL each time,once at interval of 2-3 h until the transition to common food.Results The recovery time of gastrointestinal function in the observation group was significantly shortened compared with the control group(P<0.05).The serum albumin level on postoperative 1,35 d in the observation group were somewhat decreased compared with before operation(P<0.05),but slighly higher than that in the control group(P<0.05).There was no occurrence of intestinal obstruction and anastomotic fistula in the observation group,only each 1 case of nausea,vomitting and abdominal dis

关 键 词：结肠切除术 进食 早期 肠功能 

分 类 号：R473.6[医药卫生—护理学]