Khan Niyaz Ahmed, Roy Choudhury Subhasis, Yadav Partap Singh, Prakash Raghu, Patel Jigar N
Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, 110001, India.
Pediatr Surg Int. 2017 Feb;33(2):229-234. doi: 10.1007/s00383-016-4019-6. Epub 2016 Nov 10.
Nasogastric tubes are being routinely used in children and adults undergoing elective abdominal surgery without much scientific evidence supporting their true usefulness. The aim of our study was to assess the role of nasogastric tube in children undergoing elective distal bowel surgery.
All pediatric patients undergoing elective distal bowel surgery were enrolled and randomized into two groups: those with nasogastric tube (NG group) or without nasogastric tube (NNG group). Outcome parameters such as resumption of bowel function, enteral feed tolerance, postoperative complications, hospital stay and patient with their parent satisfaction were compared between the groups.
A total of 60 patients were included with equal distribution in the NG and NNG groups. Patient variables were comparable in both the groups. Patients in NNG group progressed to full oral feeds significantly earlier (57 ± 18 vs. 106.07 ± 18.35 h, p < 0.001) and had shorter duration of hospital stay (91.93 ± 26.03 vs. 114.67 ± 18.83 h, p < 0.001) as compared to the NG group. Significant number of patients with nasogastric tube reported sore throat (9 vs. 1 p = 0.03) and nausea (5 vs. 0 p = 0.010). There was no significant difference in return of bowel function (39.43 h ± 15.92 vs. 43.60 h ± 17.77, p = 0.171), hiccups, sleep disturbance, complications and nasogastric tube reinsertion rate between the two groups.
Routine use of nasogastric tube after elective distal bowel surgery in children is not necessary.
鼻胃管在接受择期腹部手术的儿童和成人中常规使用，但缺乏足够的科学证据支持其实际效用。我们研究的目的是评估鼻胃管在接受择期远端肠道手术的儿童中的作用。
所有接受择期远端肠道手术的儿科患者均被纳入并随机分为两组：留置鼻胃管组（NG组）和未留置鼻胃管组（NNG组）。比较两组患者的肠道功能恢复、肠内喂养耐受性、术后并发症、住院时间以及患者及其家长的满意度等结果参数。
共纳入60例患者，NG组和NNG组各30例。两组患者的变量具有可比性。与NG组相比，NNG组患者更早开始完全经口喂养（57±18小时vs.106.07±18.35小时，p<0.001），住院时间更短（91.93±26.03小时vs.114.67±18.83小时，p<0.001）。留置鼻胃管的患者中，有相当数量的患者报告喉咙痛（9例vs.1例，p = 0.03）和恶心（5例vs.0例，p = 0.010）。两组在肠道功能恢复时间（39.43小时±15.92小时vs.43.60小时±17.77小时，p = 0.171）、打嗝、睡眠障碍、并发症及鼻胃管重新插入率方面无显著差异。
儿童择期远端肠道手术后常规使用鼻胃管并无必要。
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