Reasbeck P G, Rice M L, Herbison G P
Surg Gynecol Obstet. 1984 Apr;158(4):354-8.
Despite some evidence that gastric decompression may be unnecessary after some abdominal operations and in the treatment of paralytic ileus, the use of nasogastric suction after extensive abdominal operations, particularly intestinal resection, remains a subject of some debate. In a randomized prospective trial, 52 patients with suture lines constructed in the gastrointestinal tract received no postoperative nasogastric drainage unless acute gastric dilation or copious vomiting developed postoperatively, while 45 similar patients were allocated to receive routine postoperative nasogastric aspiration. Only 12 patients in the nonintubated group required subsequent insertion of a nasogastric tube, while in the remaining 40, nasogastric drainage was avoided completely. Postoperative loss of fluid from the intestine was significantly greater in the patients undergoing routine nasogastric drainage, although the requirement for intravenous fluid therapy was the same in both groups. There were no significant differences between the two groups in the incidence of postoperative complications. Routine nasogastric aspiration after gastric or intestinal resection does not confer significant advantages to outweigh its discomfort and potential morbidity for patients and should be replaced by selective intubation when required postoperatively.
尽管有证据表明，在某些腹部手术后以及治疗麻痹性肠梗阻时，胃减压可能并无必要，但在广泛的腹部手术后，尤其是肠道切除术后，使用鼻胃吸引术仍存在一些争议。在一项随机前瞻性试验中，52例胃肠道构建了缝合线的患者，除非术后出现急性胃扩张或大量呕吐，否则术后不进行鼻胃引流，而45例类似患者被分配接受常规术后鼻胃抽吸。非插管组中只有12例患者随后需要插入鼻胃管，而其余40例患者完全避免了鼻胃引流。接受常规鼻胃引流的患者术后肠道液体丢失明显更多，尽管两组的静脉输液治疗需求相同。两组术后并发症的发生率没有显著差异。胃或肠道切除术后常规鼻胃抽吸并没有显著优势来抵消其给患者带来的不适和潜在发病率，术后应根据需要采用选择性插管来取代它。
