鼻胃管胃肠减压在择期腹部手术中的应用价值

鼻胃管胃肠减压曾被常规应用于择期和急诊的腹部手术后，目的是预防急性胃扩张的发生、治疗梗阻、降低吻合口压力等。但是，鼻胃管置入也会带来一些副作用，如呼吸道并发症、胃-食道反流、体液和电解质的丢失、声带的损伤，以及越来越被重视的患者的不适感。近年来的研究结果也对择期的腹部手术后常规应用鼻胃管胃肠减压提出不同的看法。现重新评价应用鼻胃管胃肠减压的理论基础及相关临床研究的结果，并对鼻胃管胃肠减压在择期腹部手术中的价值作一综述。

Nasogastric intubation in the elective abdominal surgery

Nasogastric tube is used routinely after both elective and emergency abdominal surgery for gastrointestinal decompression, to prevent acute gastric dilatation, treat ileus, monitor upper gastrointestinal haemorrhage, act as a guide to starting oral feeding, and to reduce tension on suture lines. However, the use of nasogastric tube may result in some morbidities, such as respiratory complications, gastro-oesophageal reflux, fluid and electrolye losses, injury to the vocal folds and discomfort feeling which is being higher thought than before. And recently some studies suggested that there might be fewer evidences support the routine use of nasogastfic tube in elective abdominal surgery. In this paper the rationale of gastrointestinal decompression and the related clinical trials are reviewed, and the value of the gastrointestinal decompression in elective abdominal surgery is reappraised.