Tanguy Michèle, Seguin Philippe, Mallédant Yannick
Service d'Anesthésie Réanimation 1, Hôpital de Pontchaillou, rue Henri le Guilloux, 35033 Rennes Cedex 9, France
Crit Care. 2007;11(1):201. doi: 10.1186/cc5118.
This article provides a summary of current information on rational postoperative use of the nasogastric tube, based on a review of literature related to postoperative gastrointestinal discomfort and management with the nasogastric tube. Routine gastric decompression after major surgery neither hastens the return of bowel function nor diminishes the incidence of postoperative nausea and vomiting. The multimodal postoperative rehabilitation programme is a modern and more efficient approach. Omission of nasogastric tube decompression does not increase the incidence of anastomotic leakage or wound dehiscence. Conversely, early enteral feeding is feasible and safe, favours local immunity and gut integrity, and improves nutritional status. With the objective to feeding, nasogastric tube could be used in selected patients. To conclude, use of the nasogastric tube to prevent or limit postoperative gastrointestinal discomfort must be challenged. In contrast to gastric decompression, early gastric feeding must be considered within the new concept of fast track surgery.
本文基于对术后胃肠道不适及鼻胃管管理相关文献的综述，总结了当前关于鼻胃管合理术后使用的信息。大手术后常规胃减压既不能加速肠功能恢复，也不能降低术后恶心呕吐的发生率。多模式术后康复方案是一种现代且更有效的方法。省略鼻胃管减压不会增加吻合口漏或伤口裂开的发生率。相反，早期肠内喂养是可行且安全的，有利于局部免疫和肠道完整性，并改善营养状况。出于喂养目的，鼻胃管可用于特定患者。总之，使用鼻胃管预防或限制术后胃肠道不适必须受到质疑。与胃减压相反，在快速康复外科的新概念中必须考虑早期胃喂养。
