Bauer J J, Gelernt I M, Salky B A, Kreel I
Ann Surg. 1985 Feb;201(2):233-6. doi: 10.1097/00000658-198502000-00017.
Controversy exists regarding the need for nasogastric tube decompression and the incidence of complications resulting from its use following major intra-abdominal surgery. To determine the value of such tubes, 100 patients were managed after surgery with a nasogastric tube in situ until the passage of flatus per rectum (Group I). In a second group of 100 patients, no nasogastric tube was placed after surgery unless vomiting, gross distention, or overt obstruction occurred (Group II). In Group I, the nasogastric tube remained in place an average of 6 days and five patients required replacement of the tube after its initial removal. In Group II, nasogastric intubation was required at some point after surgery in six patients. No aspiration pneumonia, nasal septum necrosis, anastomotic leak, or wound dehiscence was seen in either group. There were three wound infections in Group I and two in Group II. The most obvious difference was the increased comfort and mobility of the group of patients treated without routine nasogastric decompression (Group II). Routine use of the nasogastric tube adjunct to patient care following gastrointestinal tract surgery may be safely eliminated.
关于腹部大手术后是否需要鼻胃管减压以及使用鼻胃管所导致的并发症发生率，目前仍存在争议。为了确定此类管道的价值，对100例患者术后进行了鼻胃管留置处理，直至直肠排气（第一组）。在另一组100例患者中，术后除非出现呕吐、严重腹胀或明显梗阻，否则不放置鼻胃管（第二组）。在第一组中，鼻胃管平均留置6天，5例患者在初次拔除后需要更换鼻胃管。在第二组中，6例患者术后在某个时间点需要进行鼻胃管插管。两组均未出现吸入性肺炎、鼻中隔坏死、吻合口漏或伤口裂开。第一组有3例伤口感染，第二组有2例。最明显的差异是未进行常规鼻胃管减压治疗的患者组（第二组）舒适度和活动能力有所提高。胃肠道手术后常规使用鼻胃管辅助患者护理或许可以安全地摒弃。
