| 摘要: |
| 目的探讨不放置胃管对腹腔镜手术结直肠癌患者术后恢复的影响。方法选择行腹腔镜下结直肠癌手术的203例患者为对象，分为观察组（不放置胃管）99例和对照组（常规放置胃管）104例，比较两组患者术后一般情况、免疫球蛋白水平、C反应蛋白（CRP）水平及并发症发生率。结果观察组术前不适感、恶心、呕吐、濒死感等发生率均明显低于对照组（均P＜0.05），术后首次发生肠鸣音、排气及排便时间均比对照组短（均P＜0.05），且住院费用明显低于对照组（P＜0.05）。术前两组患者CRP水平比较差异无统计学意义（P＞0.05）；术后1~4d，观察组CRP水平均明显高于术前（均P＜0.05），其中术后2、3d观察组CRP水平均明显低于对照组（均P＜0.05）。术前两组患者免疫球蛋白A（IgA）、免疫球蛋白M（IgM）和免疫球蛋白G（IgG）水平比较，差异均无统计学意义（均P＞0.05）；术后8d观察组IgA、IgM和IgG水平均高于对照组，其中两组IgM、IgG水平比较差异有统计学意义（均P＜0.05），IgA水平比较差异无统计学意义（P＞0.05）。观察组失眠发生率低于对照组（P＜0.05），而两组恶心、呕吐、切口感染、肺炎、菌血症等并发症发生率比较，差异均无统计学意义（均P＞0.05）。结论不放置胃管可促进腹腔镜下结直肠癌术后恢复；为避免肺炎发生，建议术前评估患者年龄、胃食管反流等情况后考虑是否放置胃管。 |
| 关键词: 胃管置入 腹腔镜 结直肠癌 术后恢复 |
| DOI：10.12056/j.issn.1006-2785.2017.39.6.2016-1574 |
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| Postoperative recovery in colorectal cancer patients undergoing laparoscopic surgery without retaining nasogastric tube |
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WANG Jzongpan, CHEN Zhenhong
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Quzhou People's Hospital
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| Abstract: |
| Objective To assess the postoperative recovery in colorectal cancer patients undergoing laparoscopic surgery without retaining nasogastric tube. Methods Total 203 colorectal cancer patients undergoing laparoscopy in our hospital were enrolled in the study, including 99 patients without retaining nasogastric tube (study group) and 104 patients with retaining nasogastric tube (control group). The general conditions after surgery, levels of immune globulin and C-reactive protein (CRP), and postoperative complications were compared between two groups. Results The rates of preoperative discomfort, nausea, vomiturition and feeling of impending death were lower in study group than those in control group (all P＜0.05). The first borborygmus, first exhaust and first defecation were earlier, and the hospitalization expense was less in study group than those in control group (all P＜0.05).There was no significant difference in CRP level between two groups before operation (P ＞0.05), the CRP levels in control group at postoperative d1 to d4 were higher than those preoperative(all P＜0.05), and at postoperative d2 to d3 were lower than those in control group (P＜0.05). There are no statistically differences in levels of IgA, IgM and IgG between two groups before surgery (all P ＞0.05), the IgM and IgG levels in study group at postoperative d8 were higher than those in control group (all P＜0.05), but no difference in IgA level (P ＞0.05). The rate of insomnia was lower in study group than that in control group (P＜0.05), while there were no significant differences in rates of nausea, vomit, incision infection, pneumonia and bacteremia between two groups (all P ＞0.05). Conclusion It is little influence on postoperative recovery in colorectal cancer patients undergoing laparoscopic surgery whether nasogastric tube being retained, and decision can be made by assessing the age of patients and whether have gastroesophageal reflux. |
| Key words: Nasogastric tube Laparoscopy Colorectal carcinoma Postoperation recovery |
