胸腹腔镜食管癌术后不留置胃管安全性和成本效益的前瞻性队列研究  

Safety and cost-benefit analysis of patients without gastric tube after thoracolaparoscopic esophagectomy:A prospective cohort study

作　　者：尹媛媛 郑娥 李欢欢 杨梅 姚丽 赵春林 YIN Yuanyuan;ZHENG E;LI Huanhuan;YANG Mei;YAO Li;ZHAO Chunlin(West China School of Nursing,Sichuan University,Department of Thoracic Surgery,West China Hospital,Sichuan University,Chengdu,610000,P.R.China;West China School of Nursing,Sichuan University,Mental Health Center,West China Hospital,Sichuan University,Chengdu,610000,P.R.China)

机构地区：[1]四川大学华西护理学院/四川大学华西医院胸外科,成都610000 [2]四川大学华西护理学院/四川大学华西医院心理卫生中心,成都610000

出　　处：《中国胸心血管外科临床杂志》2024年第5期728-732,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：四川大学华西护理学科发展专项基金(HXHL19022;HXHL19049)。

摘　　要：目的比较食管癌患者术后有无胃管留置的安全性和舒适度,分析胃管留置的成本和护理时间。方法前瞻性纳入2021年在四川大学华西医院行食管癌微创手术患者,按术中是否留置胃管将患者分为胃管留置组和无胃管留置组,比较两组安全性和舒适度指标。结果纳入患者130例。胃管留置组66例,其中男53例、女13例,平均年龄(61.80±9.05)岁;无胃管留置组64例,其中男55例、女9例,平均年龄(64.47±8.00)岁。无胃管留置组有6例在术后1~3 d因病情需要安置胃管,两组患者术后并发症发生率差异无统计学意义(P>0.05)。胃管留置组患者主观舒适感明显低于无胃管留置组(P<0.001),喉咙异物感发生率高于无胃管留置组(P<0.001)。胃管留置组患者人均护理时间约59.58 min,人均胃管材料和护理费用378.24元。结论对合适的食管癌患者术后不常规留置胃管不会增加患者术后并发症(肺部感染、吻合口漏、乳糜胸)发生率,可增加患者的舒适感、节约费用、减少护理工作量,具有安全性、可行性、经济性。Objective To compare the safety and comfort of patients with or without postoperative gastric tube placement after esophageal cancer surgery,and analyze the cost and nursing time of gastric tube placement.Methods The patients with esophageal cancer undergoing minimally invasive surgery in West China Hospital of Sichuan University in 2021 were enrolled.The patients were divided into a gastric tube indwelling group and a non gastric tube indwelling group according to whether the gastric tube was indwelled after the operation.The safety and comfort indicators of the two groups were compared.Results A total of 130 patients were enrolled.There were 66 patients in the gastric tube indwelling group,including 53 males and 13 females,aged 61.80±9.05 years and 64 patients in the non gastric tube indwelling group,including 55 males and 9 females,aged 64.47±8.00 years.Six patients in the non gastric tube indwelling group needed to place gastric tube 1 to 3 days after the operation due to their condition.There was no statistical difference in the incidence of postoperative complications between the two groups(P>0.05).The subjective comfort of patients in the gastric tube indwelling group was significantly lower than that in the non gastric tube indwelling group(P<0.001),and the incidence of foreign body sensation in the throat of patients in the gastric tube indwelling group was higher than that in the non gastric tube indwelling group(P<0.001).The average nursing time in the gastric tube indwelling group was about 59.58 minutes,and the average cost of gastric tube materials and nursing was 378.24 yuan per patient.Conclusion No gastric tube used after operation for appropriate esophageal cancer patients will not increase the incidence of postoperative complications (pulmonary infection, anastomotic leakage, chylothorax), but can increase thecomfort of patients, save cost and reduce nursing workload, which is safe, feasible and economical.

关 键 词：胸腹腔镜 食管癌手术 留置胃管 成本效益 

分 类 号：R473.73[医药卫生—护理学]