下消化道切除吻合术应用胃肠减压的临床研究

目的 探讨术后应用胃肠减压在下消化道手术中的临床意义。方法 将368例下消化道切除吻合术患者分为术后胃肠减压组与术后无胃肠减压组，比较两组的临床治疗效果及并发症发生情况。结果 减压组术后引流胃液量约200ml／d，两组术前腹围均小于术后各日腹围。两组肛门排气、排便时间无差异。总的并发症发生率减压组(28．0％)明显高于未减压组(8．2％)，减压组咽喉炎发生率达23．1％。术后平均住院时间两组间无差异。结论 下消化道切除吻合手术后应用胃肠减压，难以起到有效降低胃肠道压力的作用，对防止术后并发症无明显作用，反而会增加咽喉炎等并发症的发病率，不置胃肠减压有利于患者的恢复。

Clinical Study of Gastrointestinal Decompression after Excision and Anastomosis of Lower Digestive Tract

Objective To discuss the clinical significance of postoperative application of gastrointestinal decompression after anastomosis of lower digestive tract. Methods Three hundred and sixty-eight patients undergoing excision and anastomosis of lower digestive tract were divided into two groups: the group with postoperative gastrointestinal decompression and the group without it. The clinical therapeutic outcomes and incidences of complications were compared between the two groups. Results The volume of gastric juice in the decompression group was about 200 ml every day after operation. Both groups had a smaller abdomenal circumference before operation than after operation ( P <0.001). No difference in the time of first passage of gas from anus and defecation after operation was found between the two groups. The incidence of complications in the decompression group was obviously higher than that of non-decompression group (28.0% vs. 8.2%, P <0.001); the incidence of pharyngolaryngitis of the former was up to 23.1%. There was also no difference found between these two groups regarding the hospital stay after operation.Conclusion The present study shows that application of gastrointestinal decompression after excision and anastomosis of lower digestive tract cannot effectively reduce the gastrointestinal tract pressure and has no obvious effect on prevention from postoperative complications. On the contrary, it may increase the incidence of pharyngolaryngitis and other complications. Therefore, it is more beneficial for the recovery of patients without gastrointestinal decompression.