• 四川大學(xué)華西醫(yī)院普外科（成都610041）;

目的  探討術(shù)后應(yīng)用胃腸減壓在下消化道手術(shù)中的臨床意義。
方法  將368例下消化道切除吻合術(shù)患者分為術(shù)后胃腸減壓組與術(shù)后無胃腸減壓組，比較兩組的臨床治療效果及并發(fā)癥發(fā)生情況。
結(jié)果  減壓組術(shù)后引流胃液量約200 ml/d，兩組術(shù)前腹圍均小于術(shù)后各日腹圍。兩組肛門排氣、排便時間無差異?？偟牟l(fā)癥發(fā)生率減壓組(28.0%)明顯高于未減壓組(8.2%),減壓組咽喉炎發(fā)生率達(dá)23.1%。術(shù)后平均住院時間兩組間無差異。
結(jié)論  下消化道切除吻合手術(shù)后應(yīng)用胃腸減壓, 難以起到有效降低胃腸道壓力的作用,對防止術(shù)后并發(fā)癥無明顯作用，反而會增加咽喉炎等并發(fā)癥的發(fā)病率, 不置胃腸減壓有利于患者的恢復(fù)。

引用本文： 趙高平,雷文章,李卡,程中,王天才. 下消化道切除吻合術(shù)應(yīng)用胃腸減壓的臨床研究. 中國普外基礎(chǔ)與臨床雜志, 2004, 11(6): 512-514. doi: 復(fù)制

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  1. 1. Clevers GJ, Smout AJ. The natural course of postoperative ileus following abdominal surgery [Ｊ]. Neth J Surg, 1989; 41(5)∶ 97.
  2. 2. 黎介壽，吳孟超，黃志強(qiáng)主編. 手術(shù)學(xué)全集·普通外科卷 [M]. 第1版. 北京： 人民軍醫(yī)出版社， 1996∶344～548.
  3. 3. 應(yīng)福明. 無鼻胃管減壓膽道手術(shù)112例報(bào)告 [Ｊ]. 臨床外科雜志， 1999； 7（2）∶104.
  4. 4. 唐元生，張秀珍，韓殿承主編. 人體醫(yī)學(xué)參數(shù)與概念 [M]. 第1版. 濟(jì)南： 濟(jì)南出版社， 1995∶80～115.
  5. 5. Argov S, Goldstein I, Barzilai A. Is routine use of the nasogastric tube justified in upper abdominal surgery? [Ｊ]. Am J Surg, 1980; 139(6)∶849.
  6. 6. Nathan BN, Pain JA. Nasogastric suction after elective abdominal surgery: a randomised study [Ｊ]. Ann R Coll Surg Engl, 1991; 73(5)∶291.
  7. 7. Michowitz M, Chen J, Waizbard E, et al. Abdominal operations without nasogastric tube decompression of the gastrointestinal tract [Ｊ]. Am Surg, 1988; 54(11)∶672.
  8. 8. Koukouras D, Mastronikolis NS, Tzoracoleftherakis E, et al. The role of nasogastric tube after elective abdominal surgery [Ｊ]. Clin Ter, 2001; 152(4)∶241.
  9. 9. Hoffmann S, Koller M, Plaul U, et al. Nasogastric tube versus gastrostomy tube for gastric decompression in abdominal surgery: a prospective, randomized trial comparing patients’ tuberelated inconvenience [Ｊ]. Langenbecks Arch Surg, 2001; 386(6)∶402.
  10. 10. Gouzi JL, Moran B. Nasogastric tubes after elective abdominal surgery is not justified [Ｊ]. J Chir (Paris), 1998; 135(6)∶273.