鼻胃管对幽门狭窄婴儿住院时间的术后影响（POINTS）：一项前瞻性随机对照试验。

Post-Operative Impact of Nasogastric Tubes on length of stay in infants with pyloric Stenosis (POINTS): A prospective randomized controlled pilot trial.

作者信息

Flageole Helene H, Pemberton Julia

机构信息

Department of Surgery, McMaster University, Hamilton, ON Canada; McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON Canada; McMaster Pediatric Surgery Research Collaborative, Department of Surgery, McMaster University, Hamilton, ON Canada.

Department of Surgery, McMaster University, Hamilton, ON Canada; McMaster Pediatric Surgery Research Collaborative, Department of Surgery, McMaster University, Hamilton, ON Canada.

出版信息

J Pediatr Surg. 2015 Oct;50(10):1681-5. doi: 10.1016/j.jpedsurg.2015.02.023. Epub 2015 Feb 19.

DOI:10.1016/j.jpedsurg.2015.02.023

PMID:25783381

Abstract

INTRODUCTION

Postoperative emesis commonly affects infants after pyloromyotomy for pyloric stenosis. This randomized controlled trial investigates the impact of preoperative nasogastric tubes (NGTs) on postoperative emesis rate and length of stay (LOS).

METHODS

Patients from January 2010 to June 2012 were screened and randomized to have an 8 French NGT or no NGT inserted prior to surgery. Patients contraindicated for NGT or pyloromyotomy, those < 6 months of age, born prematurely, or with cardiac malformations were excluded. Patient demographics, blood work, postoperative feeding, postoperative emesis rate, and postoperative LOS were collected. Student's t test and Fisher's exact test were used to compare postoperative emesis rate and LOS.

RESULTS

Of 125 patients screened, 65 (52%) were eligible, and 50 (77%) were recruited. The NGT (n = 25) and no NGT (n = 25) groups had no significant difference in baseline characteristics. Postoperative emesis occurred in 17 (68%) patients with NGT compared to 12 (48%) in patients with no NGT (p = 0.25). Postoperative emesis events (52 [23%] vs. 47 [20%], p = 0.50), emesis per patient (2.08 ± 2.23 vs. 1.88 ± 2.70, p = 0.76 95% CI: -1.21 to 1.61), and LOS (34.77 ± 13.74 vs. 36.33 ± 19.36, p = 0.74 95% CI: -11.11 to 7.98) were similar between NGT and no NGT groups.

CONCLUSION

Preoperative NGT insertion had no demonstrable effect on LOS or postoperative emesis rate after pyloromyotomy.

摘要

引言

幽门肌切开术治疗幽门狭窄后，术后呕吐是影响婴儿的常见问题。本随机对照试验研究术前鼻胃管（NGT）对术后呕吐发生率和住院时间（LOS）的影响。

方法

对2010年1月至2012年6月期间的患者进行筛查，并随机分为术前插入8号法国规格鼻胃管组或不插入鼻胃管组。排除有鼻胃管或幽门肌切开术禁忌证、年龄小于6个月、早产或有心脏畸形的患者。收集患者人口统计学资料、血液检查结果、术后喂养情况、术后呕吐发生率及术后住院时间。采用学生t检验和Fisher精确检验比较术后呕吐发生率和住院时间。

结果

在筛查的125例患者中，65例（52%）符合条件，50例（77%）被纳入研究。鼻胃管组（n = 25）和无鼻胃管组（n = 25）的基线特征无显著差异。鼻胃管组17例（68%）患者发生术后呕吐，无鼻胃管组为12例（48%）（p = 0.25）。术后呕吐事件（52 [23%] 对47 [20%]，p = 0.50）、每名患者的呕吐次数（2.08 ± 2.23对1.88 ± 2.70，p = 0.76，95%CI：-1.21至1.61）以及住院时间（34.77 ± 13.74对36.33 ± 19.36，p = 0.74，95%CI：-11.11至7.98）在鼻胃管组和无鼻胃管组之间相似。