Clevers G J, Smout A J
Department of Surgery, University Hospital, State University Utrecht, The Netherlands.
Neth J Surg. 1989 Oct;41(5):97-9.
Postoperative ileus is a normal, transient condition following surgical procedures of the abdomen. The restoration of gastrointestinal motility was studied in 50 patients who had abdominal surgery. The motility was evaluated by means of physical signs and clinical symptoms. Physical signs, such as bowel sounds, passage of first flatus and defecation, occurred on relatively constant moments in the postoperative period and did not depend on the type of operation. In the patients who had rectopexy, flatus and defecation passed significantly later, probably due to existing defecation problems before the operation. The moment of resumption of a normal diet varied greatly. None of the physical signs had a predictive value with regard to postoperative nausea or vomiting. No relation could be demonstrated between the moment of removal of the nasogastric tube and the volume of gastric aspirate drained by the tube. The period of postoperative drainage of the stomach in comparable patient groups differed strongly from ward to ward. More attention for nasogastric tube management following abdominal surgery seems desirable. Early removal of the tube is possible in most patients and diminishes unnecessary discomfort.
术后肠梗阻是腹部手术后的一种正常、短暂的状况。对50例接受腹部手术的患者的胃肠动力恢复情况进行了研究。通过体征和临床症状对胃肠动力进行评估。诸如肠鸣音、首次排气和排便等体征在术后相对固定的时间出现，且不取决于手术类型。在接受直肠固定术的患者中，排气和排便明显延迟，这可能是由于术前存在排便问题。恢复正常饮食的时间差异很大。没有任何体征对术后恶心或呕吐具有预测价值。鼻胃管拔除时间与通过该管引出的胃吸出物量之间未显示出相关性。在可比的患者组中，各病房术后胃引流的时间差异很大。腹部手术后似乎需要更多关注鼻胃管管理。大多数患者可以早期拔除鼻胃管，这可减少不必要的不适。
