腹腔镜下胃癌根治术后未留置鼻胃管的安全性和可行性

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (615 KB)
输出: BibTeX | EndNote (RIS)

摘要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。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	刘烺飚
	牛磊
	尹杰
	蔡军
	韩承新

关键词 ：腹腔镜, 胃癌, 鼻胃管, 近期疗效

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.

Key words： laparoscopy gastric cancer nasogastric tube short-term effect

收稿日期: 2021-04-10

ZTFLH:

R656.6

通讯作者: 韩承新,E-mail:hcxhyfhq@sina.com

作者简介: 刘烺飚,硕士,主治医师。

引用本文:

刘烺飚, 牛磊, 尹杰, 蔡军, 韩承新. 腹腔镜下胃癌根治术后未留置鼻胃管的安全性和可行性[J]. 武警医学, 2021, 32(11): 950-953. LIU Langbiao, NIU Lei, YIN Jie, CAI Jun, HAN Chengxin. Safety and feasibility of leaving no nasogastric tube after laparoscopic gastrectomy for gastric cancer. Med. J. Chin. Peop. Armed Poli. Forc., 2021, 32(11): 950-953.

链接本文:

http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2021/V32/I11/950

[1]	王少明, 郑荣寿, 张思维, 等. 2015年中国胃癌流行特征分析[J]. 中华流行病学杂志, 2019, 40(12):1517-1521.
[2]	Marino V, Riccardo V, Theodoros R,et al.Gastric cancer: epidemiology, prevention, and therapy[J].Helicobacter, 2018,23(Suppl 1):e12518.
[3]	李国新, 张镇展, 刘浩,等. 中国腹腔镜胃癌外科的发展与启示[J]. 中华普通外科杂志, 2018, 33(1):1-3.
[4]	Zhaoyang T.Recent advances in the surgical treatment of advanced gastric cancer: a review[J]. Med Sci Monit, 2019,25:3537-3541.
[5]	王棣祥,王家兴,李捷,等. 腹腔镜辅助远端胃癌根治术对老年进展期胃癌的短期疗效[J]. 武警医学, 2019, 30(6):479-483.
[6]	羊鑫, 吕剑, 徐传奇,等. 胃肠减压在根治性近端胃癌切除术后的应用[J]. 江苏医药, 2018, 44(12):122-124.
[7]	Balentine C J,Richardson P A,Mason M C,et al. Postacute care and recovery after cancer surgery: still a long way to go[J]. Ann Surg,2017,265: 993-999.
[8]	Siegel R, Naishadham M A, Ahmedin J D. Cancer statistics, 2013 [J]. CA Cancer J Clin, 2013, 63(1):11-30.
[9]	Wilmore D W,Kehlet H. Management of patients in fast track surgery[J]. BMJ,2001,322(7284):473-476.
[10]	Lassen K,Soop M,Nygren J,et al. Consensus review of optimal perioperative care in colorectal surgery: enhanced recovery after surgery (ERAS) group recommendations[J].Arch Surg,2009,144(10):961-969.
[11]	Yamagata Y,Yoshikawa T. Current status of the "enhanced recovery after surgery" program in gastric cancer surgery[J].Ann Gastroenterol Surg, 2019,3(3):231-238.
[12]	梅佳玮,李琛,项明,等. 胃肠减压在胃切除术后临床应用的前瞻性临床随机对照试验[J]. 中华胃肠外科杂志,2009,12(5):452-455.
[13]	Mattei P,Rombeau J L.Review of the pathophysiology and management of postoperative ileus[J]. World J Surg,2006,30(8):1382.
[14]	夏灿灿, 刘江, 赵健,等. 加速康复外科胃癌患者术后不常规留置导尿管的可行性加速康复外科胃癌患者术后不常规留置导尿管的可行性[J]. 协和医学杂志,2020,11(1):49-53.
[15]	王玉, 王宏磊, 赵永捷,等. 胃癌根治术后早期肠内营养支持对患者术后恢复及营养状态的影响[J]. 中国老年保健医学, 2018, 16(5):67-69.
[16]	曹璐,李萍,赵晓智. 泌尿系机器人辅助腹腔镜手术胃管的置入与拔除时机研究[J]. 护士进修杂志,2019,32(3):390-393.
[17]	Yoo C H, Son B H, Han W K, et al. Nasogastric decompression is not necessary in operations for gastric cancer: prospective randomised trial[J].Eur J Surg, 2002,168:379-383.