结直肠内镜黏膜下剥离术后早期进食时机的临床研究  

Clinical study of early feeding after colorectal mucosal dissection

作　　者：黄娟娟[1] 卢晓云 苏洁[1] 汪翰英 周莹[1] 陈露[1] HUANG Juanjuan;LU Xiaoyun;SU Jie;WANG Hanying;ZHOU Ying;CHEN Lu(Digestive Endoscopy Center,Jiangsu Province Hospital of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]江苏省中医院消化内镜中心,江苏南京210029

出　　处：《安徽医学》2022年第4期391-395,共5页Anhui Medical Journal

基　　金：江苏省中医院面上项目(项目编号:y19047)。

摘　　要：目的探讨结直肠内镜黏膜下剥离术(ESD)后不同的进食时机对患者术后并发症、住院时间及舒适度的影响。方法选取2018年9月至2019年9月南京中医药大学附属医院消化内镜中心住院并行结直肠ESD术的患者共145例,采用倾向性匹配分析,根据患者术后进食时间纳入试验组(进食时间≤24 h)及对照组(进食时间>24 h),每组各35例,分析两组患者性别、年龄、病灶部位、病灶大小(短径、长径、面积)、术后并发症(出血、穿孔、发热)、住院时间(总住院时间、术后住院时间)、术后舒适度调查项目(恶心、失眠、腰背部不适、腹痛、饥饿感、口渴)的差异性。结果经倾向性匹配后,两组患者进食后的出血发生率、穿孔发生率、发热发生率,差异无统计学意义(P>0.05);试验组术后住院时长较对照组住院时长短,差异有统计学意义[(4.49±1.58)天比(5.23±1.14)天,P<0.05];在舒适度调查项目方面,两组患者口渴发生率度方面,差异有统计学意义(P<0.05),而在恶心、失眠、腰背部不适、腹痛、饥饿感等发生率比较,差异无统计学意义(P>0.05)。结论与常规的术后进食方案相比,早期进食并不会增加结直肠ESD术后的并发症发生率,不影响术后舒适度,但能缩短患者的住院时间。Objective To investigate the effects of different feeding time after colorectal endoscopic submucosal dissection(ESD)on postoperative complications,length of hospitalstay and comfortof patients.Methods A total of 145 patients who were hospitalizedwith colorectal ESD in digestive Endoscopy Center of Affiliated Hospital of Nanjing University of Chinese Medicine from September 2018 to September 2019 were enrolled in this study.According to the postoperative eating time,35 patients in the experimental group(eating time≤24 h)and 35 patients in the control group(eating time>24 h)were finally includedusing propensity score matching analysis.The gender,age,focal lesion locations,the size(diameter,length to diameter,area),postoperative complications(bleeding,perforation,fever),length of hospital stay(total length of hospital stay,postoperative hospital stay,postoperative comfort survey project(nausea,insomnia,waist and back discomfort,abdominal pain,hunger,thirst)of the two groups were analyzed.Results After propensity score matching analysis,there was no statistical difference in the incidence of bleeding,perforation and fever between the two groups(P>0.05).The length of postoperative hospitalization in the experimental group was significantly different from that in the control group[(4.49±1.58)days vs(5.23±1.14)days,P<0.05)].In terms of comfort survey items,there was statistical difference in thirst degree between the two groups(P<0.05),while there was no statistical difference in nausea,insomnia,lumbar and back discomfort,abdominal pain,hunger and other degrees(P>0.05).Conclusions Compared with conventional postoperative feeding plan,early feeding does not increase the incidence of complications and affect postoperative comfort after colorectal ESD,but it can shorten the hospital stay of patients.

关 键 词：早期进食 内镜黏膜下剥离术 倾向性匹配分析 

分 类 号：R735.34[医药卫生—肿瘤]