Effect of different clinical interventions for gastric tube in patients undergoing gastrointestinal operations on the risk of postoperative complications and recovery of gastrointestinal tract
10.3969/j.issn.1006-5725.2016.18.033
- VernacularTitle:胃肠手术患者胃管不同处理策略对术后并发症风险及胃肠恢复的影响
- Author:
Xiaojing FAN
- Publication Type:Journal Article
- Keywords:
Perioperative period;
Gastric tube;
Gastrointestinal surgery;
Gastrointestinal function
- From:
The Journal of Practical Medicine
2016;32(18):3060-3063
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the effect of different clinical interventions for gastric tube in patients undergoing gastrointestinal operations for measuring the risk of postoperative complications and recovery of gastrointestinal tract. Methods A total of 148 patients undergoing gastrointestinal operations were recruited and divided into Group A, B, C and D, with 37 cases in each group. All patients underwent perioperative management based on the concept of rapid rehabilitation surgery. Group A were not indwelled with gastric tube with routine method. Group B were indwelled with gastric tube with routine method and got nasogastric extubation 5 min before tracheal extubation. Group C were indwelled gastric tube with routine method and got nasogastric extubation 6 h after fully conscious of anesthesia. Group D indwell gastric tube with routine method and got nasogastric extubation 12 h after fully conscious of anesthesia. The parameters including time of the first passing of flatus, defecation and resuming peristaltic sound after operation between the groups were compared. Vasoactive Intestinal Peptide (VIP), Motilin (MTL) and Glucagon (GLU)before the operation, and at the 1st, 3rd and 7th day after operation were measured by radioimmunoassay. Results Time of the first passing of flatus, defecation and resuming peristaltic sound after operation showed a rising trend from Group A to Group D. The difference in time of the first passing of flatus was not significant (P>0.05), time of defecation and resuming peristaltic sound after operation in Group A were significantly shorter (P<0.05). There were no statistical differences in VIP, MTL, GLU among the groups before the operation and at the 1st day after operation (P>0.05). VIP in Group A at the 3rd day after operation was significantly lower than those in other 3 groups , with the increasing of time for indwelling tubes. VIP showed a rising trend. MTL showed a decreasing trend with the increasing of time for indwelling tubes at 3rd and 7th day after operation. GLU in Group A was the highest (P<0.05) . GLU showed a rising trend with the increasing of time for indwelling tubes at 3rd and 7th day after operation. GLU in Group A was the lowest (P<0.05) . The pharyngeal discomforts were least in Group A (P<0.05) .Pulmonary infection rate showed a rising trend with the increasing of time for indwelling tubes, but the difference was not significant (P>0.05). Nausea and vomiting, anastomotic fistula, intestinal obstruction, abdominal distension in 4 groups showed no significant differences (P>0.05). Conclusion Avoidance of gastric tube in gastrointestinal operations can benefit the postoperative recovery of gastrointestinal tract , reduce pharyngeal discomforts and pulmonary infections. For patients with indwelled gastric tube, the time for indwelling tubes should be shorten, in order to speed up the recovery process and improve the safety of the patients.
