目的 探讨腹腔镜下胃癌根治术后未留置胃管的安全性和可行性。方法 回顾性分析2016-01至2018-06首都医科大学附属北京友谊医院普外科收治的行腹腔镜辅助胃癌根治术患者资料,分为围术期留置鼻胃管组(对照组)和未留置鼻胃管组(观察组),每组150例,比较两组术中和术后监测指标,检测术后血红蛋白(hemoglobin,Hb) 和C反应蛋白(C reactive protein,CRP)水平,并记录并发症发生情况。结果 两组术中手术时间、出血量、输血例数差异无统计学意义(P>0.05),对照组术后首次肠鸣、首次排气时间、首次排便时间、首次开始进食时间,住院时间和住院费用均明显长于或高于观察组,差异有统计学意义 (P<0.05),术前两组Hb水平和CRP水平无明显差异,观察组术后5 d的Hb水平与对照组无明显差异,但CRP水平明显低于对照组,差异有统计学意义(P<0.05), 且观察组术后发生咽喉疼痛与肺部感染率均显著低于对照组,差异有统计学意义(P<0.05)。结论 腹腔镜辅助胃癌根治术未留置胃管能明显促进患者术后康复,缩短住院时间,降低术后肺部感染及咽喉疼痛的发生率。
Abstract
Objective To investigate the safety and feasibility of leaving no indwelling nasogastric tube after laparoscopic gastrectomy for gastric cancer. Methods The clinical data on patients who had undergone laparoscopic-assisted laparoscopic gastrectomy at the Department of General Surgery between January 2016 and June 2018 was retrospectively analyzed. The patients were divided into the perioperative indwelling nasogastric tube group (control group) and a non-indwelling nasogastric tube group (observation group), with 150 cases in each, Intraoperative and postoperative indexes of monitoring were analyzed and compared between the two groups. The postoperative levels of hemoglobin (Hb) and C-reactive protein (CRP) were measured, while complications were recorded. Results There was no statistically significant difference in the duration of surgery, bleeding volume or the number of blood transfusions between the two groups (P>0.05), while the first bowel sounds, first exhaust, first defecation and first postoperative feeding, length of hospital stay and medical cost in the control group compared much unfavorably with those in the observation group, and the difference was statistically significant (P<0.05). There was no significant difference in levels of Hb and CRP between the two groups before operation, or in Hb levels at 5 d after operation, but the CRP level was significantly lower in the observation group than in the control group (P<0.05). The postoperative rates of sore throat and pulmonary infections in the observation group were significantly lower than those in the control group (P<0.05). Conclusions Laparoscopic gastrectomy for gastric cancer without indwelling gastric tubes can significantly promote patients’ postoperative recovery, shorten hospital stay, and reduce the incidence of postoperative pulmonary infections and sore throat.
关键词
腹腔镜 /
胃癌 /
鼻胃管 /
近期疗效
Key words
laparoscopy /
gastric cancer /
nasogastric tube /
short-term effect
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