留置胃管对胃癌患者围手术期生活质量的影响

目的探讨胃癌术后留置胃管对术后恢复情况的影响。方法前瞻性纳入2009年12月至2011年3月间哈尔滨医科大学附属第三医院收治的174例胃癌患者,按随机数字表法分为试验组（88例,术中或术后第1天晨起拔除胃管）和对照组（86例,留置胃管直至排气）。比较两组患者术后不适症状、并发症发生情况、恢复时间及住院期间生活质量。结果与对照组相比,试验组患者术后恶心（14．8％比47．7％,P〈0．01）、咽痛（6．8％比38．4％,P〈0．01）、饮水后呛咳及异物感（3．4％比20．9％,P〈0．01）和咳嗽咳痰不畅（36．4％比55．8％,P〈0．05）的发生率明显降低,术后离床时间（1．46±0．58）d比（1．68±0．61）d,P〈O．05]和排气时间（3．11±0．77）d比（3．75±1．03）d,P〈0．05]明显提前。两组术后均未出现吻合口瘘及肠梗阻等严重并发症,吻合口出血发生率的差异亦无统计学意义3．4％（3／88）比5．8％（5／86）,P〉O．05]。住院期间生活质量表情评分试验组明显优于对照组（平均分3．36比2．78,P〈0．01）。结论胃癌术后早期拔除胃管是安全、合理的,可明显提高患者住院期间的生活质量。

Value of nasogastric decompression tube in patients with gastric cancer

Objective To evaluate the effect of nasogastric decompression tube after gastric cancer operation on the postoperative recovery. Methods A toal of 174 patiens with gastric cancer were prospectively enrolled from December 2009 to March 2011 and randomly divided into non- nasogastric tube control group （n=88） and nasogastric tube group （n=86）. Postoperative symptoms, complications, recovery time, and quality of life during hospital stay were compared between the two groups. Results The incidences of nausea（14.8% vs. 47.7%, P〈0.01）, sore throat（6.8% vs. 38.4%, P〈 0.01）, bucking and foreign body sensation （3.4% vs. 20.9%, P〈0.01）, expectorative obstruction （36.4% vs. 55.8%, P〈0.05） were significantly lower in nasogastrie tube group than those in the control group. The intervals to ambulation and flatus were（1.46±0.58） d and（3.11±0.77） d in the non-nasogastric tube group, significantly shorter those in nasogastric tube group （ 1.68±0.61 ） d and （3.75± 1.03 ） d ]. There was no anastomotie leak or bowel obstruction. The difference in bleeding was not statistically significant3.4%（3/88） vs. 5.8%（5/86）, P〉0.05] between the two groups. The quality of life differed between the two groups （mean score, 3.36 vs. 2.78, P〈0.01）. Conclusion Early removal of nasogastric decompression tube is safe and reasonable and can improve the quality of life during hospital stay.