Virginia Mason Medical Center, 1100 Ninth Avenue, Seattle, WA 98104, USA.
Virginia Mason Medical Center, 1100 Ninth Avenue, Seattle, WA 98104, USA.
Am J Surg. 2012 May;203(5):644-648. doi: 10.1016/j.amjsurg.2011.12.007. Epub 2012 Mar 27.
Postoperative ileus is the main determinant of the length of hospital stay after colorectal surgery. Our objective was to analyze modifiable factors, including polyethylene glycol administration, associated with the return of bowel function.
A retrospective review of all patients who underwent elective open partial colectomy from 2004 to 2006 at a single institution.
The time to the first bowel movement with and without oral intake within 48 hours postoperatively was 76 hours versus 134 hours (P < .001); with and without polyethylene glycol administration it was 73 hours versus 94 hours (P = .001); and with and without frequent ambulation it was 78 hours versus 95 hours (P = .012). With postoperative nasogastric tube drainage, the time to the first bowel movement was 22 hours longer (P = .002).
These data confirm previous findings supporting no nasogastric tube drainage, early feeding, and frequent ambulation after colorectal surgery. Additionally, our data suggest a strong association (P = .001) between the use of polyethylene glycol and the early return of bowel function.
术后肠麻痹是结直肠手术后住院时间长短的主要决定因素。我们的目的是分析可改变的因素，包括聚乙二醇的应用，与肠道功能恢复相关。
回顾性分析了 2004 年至 2006 年在一家机构接受择期开放部分结肠切除术的所有患者。
术后 48 小时内开始第一次排便且有口服摄入的时间为 76 小时，而无口服摄入的时间为 134 小时（P<0.001）；使用和不使用聚乙二醇的时间分别为 73 小时和 94 小时（P=0.001）；频繁活动和不频繁活动的时间分别为 78 小时和 95 小时（P=0.012）。术后留置鼻胃管引流时，第一次排便的时间延长了 22 小时（P=0.002）。
这些数据证实了先前支持结直肠手术后不使用鼻胃管引流、早期进食和频繁活动的研究结果。此外，我们的数据还表明，聚乙二醇的使用与肠道功能的早期恢复之间存在很强的关联（P=0.001）。
