快速康复外科在胆肠吻合术后免胃肠减压中应用

目的:探讨胆肠吻合手术病人快速康复外科中不常规留置胃肠减压管的安全性及有效性。方法:随机选取我院2010年01月至2011年01月行胆肠吻合手术的75例病人,按术前是否常规安置胃减压管分为快速康复组(n=40)及传统治疗组(n=35)。比较两组病例术后肛门恢复排气时间、咽喉疼痛、恶心呕吐、吻合口瘘、肺部感染、切口感染、术后住院时间等并发症的发生率。结果:两组病人出现吻合口瘘、肺部感染、切口感染等并发症发生率比较,差异均无统计学意义(P>0.05);快速康复组肛门恢复排气时间显著提前(P<0.05),但传统治疗组病人诉咽喉疼痛、恶心呕吐明显较快速康复组增多(P<0.01)。结论:快速康复外科不常规放置胃肠减压管用于胆肠吻合术后临床管理,可加速病人的康复。

The Value of Fast-track Surgery without Nasogastric Decompression Tube in Choledochojejtmostomy

Objective:To explore the security and feasibility without routine nasogastric decompression in patients of choledochojejtmostomy fast-track surgery.Methods:In our hospitalI from January 2010 to January 2007,seventyfive patients who received choledochojejtmostomy and were inserted nasogastric decompression tube were divided into conventional care group,and meanwhile other 40 ones without routine nasgastrie decompression tube as fast-track group.We compared their time to flatus,and the ratio of postoperative eomphcation including throat ache,nausea,atelectasis wound infection,pneumonia and anastomotic leak.The time to first passage of flatus and incidences of postoperative complications such as pharyngalgia,nausea,anastomotic fistulae,pulmonary infection,and surgical wound infection were recorded and compared between the two groups.Results:The time to first passage of flatus was significantly shorter in the as fast-track group than that of conventional care group(P<0.05).There were no significant diferences in the anastomotic fistulae,pulmonary infection and surgical wound infection between the two groups(P>0.05).The incidences of pharyngalgia,nausea and vomiting in the fast-track group were significantly lower than that of conventional care group(P<0.01).Conclusion:without nasogastric decompression tube is proved to be safe and feasible in patients of choledochojejtmostomy fast-track surgery.