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不同胃肠减压方式对胃癌根治术后患者胃肠功能恢复的影响比较

Effect of different gastrointestinal decompression methods on recovery of gastrointestinal function in patients with gastric carcinoma after radical gastrectomy

摘要:

目的:比较持续负压吸引和无负压持续吸引对胃癌根治术后胃肠功能恢复的影响。方法选取接受胃癌根治术的患者100例为研究对象,随机数字表法将患者分为观察组和对照组各50例,观察组采用无负压持续吸引胃肠减压,对照组采用负压持续吸引胃肠减压,观察并比较两组术后当天、第1、2、3天引流量,观察两组胃肠道功能恢复情况(肠鸣音恢复时间、肛门排气时间、胃管留置时间)及并发症(感染、梗阻、吻合口漏等)发生情况。结果术后当天、第1、2天,观察组引流量分别为(41.6±29.67)mL、(62.1±39.67)mL、(96.78±56.74)mL,均明显低于对照组的(55.8±31.23)mL、(75.3±42.16)mL、(96.78±56.74)mL,差异均有统计学意义(t =-2.63、-2.79、-2.40,均 P <0.05)。观察组术后胃肠道功能恢复情况优于对照组即肠鸣音恢复时间(18.68±8.21)h、肛门排气时间(69.77±7.76)h,均明显短于对照组的(32.6±12.43)h、(90.26±8.86)h,且术后胃管留置时间为(3.43±1.21)d,术后住院时间为(12.04±1.53)d,均明显短于对照组的(5.56±1.76)d、(15.26±3.16)d,差异均有统计学意义(t =-2.29、-2.87、-2.60、-2.90,均 P <0.05)。观察组存在发热、咽喉炎及肺部感染的比例分别为6%、2%、2%,明显低于对照组的18.0%、16.0%、14.0%,两组比较差异均有统计学意义(χ2=4.82、6.99、4.23,均 P <0.05)。结论胃癌根治术后无负压持续引流可促进胃肠功能恢复,缩短住院时间,减少术后并发症的发生,值得临床推广应用。

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abstracts:

Objective To compare the effect of continuous negative pressure suction and no negative pressure on functional recovery after radical gastrectomy for gastric cancer.Methods 100 patients with gastric cancer who underwent radical resection for gastric cancer from June to June 2011 were selected as the research objects,The patients were divided into observation group and control group according to the random number table method,the patients were divided into observation group and control group,50 cases.The observation group with no negative pressure continuous gastrointestinal decompression.In the control group,the negative pressure was used to attract the continuous gastrointestinal decompression,observation and comparison of the two groups of the day,2,3,1 days lead flow,Two groups were observed the recovery of gastrointestinal function (bowel sound,anal exhaust time,gastric tube indwelling time).And complications (infection,obstruction,anastomotic leakage,etc.).Results On the day,1,and 2 days after operation,the flow rate of the observation group was (41.6 ±29.67)mL,(62.1 ±39.67)mL,(96.78 ± 56.74)mL,which were significantly lower than the control group which were (55.8 ±31.23)mL,(75.3 ±42.16)mL, (96.78 ±56.74)mL,the differences were statistically significant (t =-2.63,-2.79,-2.40,all P <0.05).The observation group postoperative gastrointestinal function recovery was better than the control group,bowel sound,anal exhaust time (18.68 ±8.21 )h,(69.77 ±7.76)h,which were shorter than the control group (32.6 ±12.43)h, (90.26 ±8.86)h,And after gastric tube indwelling time and the postoperative hospitalization time was (3.43 ± 1.21)d,(12.04 ±1.53)d,shorter than those of the control group (5.56 ±1.76)d,(15.26 ±3.16)d,the difference was statistically significant (t =-2.29,-2.87,-2.60,-2.90,all P <0.05).Compared with the control group (18.0%,16.0%,14.0%),the observation group (6.0%,2.0%,2.0%)was lower in fever,sore throat and lung infection,the difference between the two groups was statistically significant (χ2 =4.82,6.99,4.23,all P <0.05). Conclusion No negative pressure drainage after radical gastrectomy for gastric cancer can promote the recovery of gastrointestinal function,shorten length of hospital stay,reduce the occurrence of postoperative complications,it is worthy of clinical popularization and application.

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