Michowitz M, Chen J, Waizbard E, Bawnik J B
Department of Surgery C, Tel-Aviv Medical Center, Israel.
Am Surg. 1988 Nov;54(11):672-5.
The routine use of nasogastric (NG) drainage during and after abdominal surgery was examined. One hundred and fifty patients who underwent various abdominal operations with a Levine tube served as a control group (retrospective group). The tubeless study group (prospective group) of 150 patients was randomly and blindly divided into three equal subgroups. Subgroup A patients were operated on without any NG tube. The tube in subgroup B patients was inserted after induction of anesthesia and removed one hour after the operation. The tube in subgroup C was inserted as in subgroup B, but was taken out 12 hours after the operation. The total number of complications in the intubated group was significantly higher than in the tubeless group (P less than 0.01). High temperature, atelectasis and miscellaneous complications were more frequent in the control group than in the study group (P less than 0.01). Other complications such as nausea, vomiting, bronchopneumonia, and gastric dilatation, as well as the resolution of the postoperative ileus and hospital stay, were not of statistical significance. Fewer miscellaneous complications (P less than 0.05) and less patient discomfort were found in subgroup A than in the other tubeless subgroups. Complications in the study group were easily controlled by conservative treatment and no serious complications resulted. Therefore, the routine use of NG suction as adjunctive therapy following abdominal operations is not advocated by this study.
对腹部手术期间及术后常规使用鼻胃管（NG）引流进行了研究。150例接受各种腹部手术并使用莱文管的患者作为对照组（回顾性组）。150例无管研究组（前瞻性组）患者被随机且盲法分为三个相等的亚组。A组患者手术时不放置任何鼻胃管。B组患者在麻醉诱导后插入鼻胃管，并在术后1小时拔除。C组鼻胃管的插入方式与B组相同，但在术后12小时拔除。插管组的并发症总数显著高于无管组（P<0.01）。对照组的高热、肺不张和其他并发症比研究组更常见（P<0.01）。恶心、呕吐、支气管肺炎和胃扩张等其他并发症，以及术后肠梗阻的缓解情况和住院时间，差异无统计学意义。A组的其他并发症较少（P<0.05），患者不适也比其他无管亚组少。研究组的并发症通过保守治疗很容易控制，未导致严重并发症。因此，本研究不提倡腹部手术后常规使用鼻胃管吸引作为辅助治疗。
