Montgomery R C, Bar-Natan M F, Thomas S E, Cheadle W G
Department of Surgery, University of Louisville School of Medicine and Veterans Administration Medical Center, Ky. 40292, USA.
South Med J. 1996 Nov;89(11):1063-6. doi: 10.1097/00007611-199611000-00007.
To determine which type of patient should receive routine postoperative nasogastric decompression (NGD), we observed 76 patients who were randomized into two groups: those who received routine NGD (n = 39) and those who received selective NGD (n = 37). Eighteen patients in the selective NGD group never required intubation, while 19 did require intubation within a mean of 3 days after surgery. In both groups, tubes remained in place for a mean of 4.7 days. The routine NGD group had a 2.5% incidence of emesis, while the selective NGD group had a 51% incidence of emesis. The return of bowel function, return to a regular diet, and postoperative length of hospital stay were similar in both groups. The patients in the selective NGD group who did not require intubation had a shorter postoperative stay. Fifty-eight percent of patients in the selective NGD group who required intubation had had major vascular or retroperitoneal dissections. These data support selective use of NGD in general surgical patients and routine use of NGD for patients having major retroperitoneal or vascular procedures.
为确定哪种类型的患者应接受术后常规鼻胃减压（NGD），我们观察了76例患者，他们被随机分为两组：接受常规NGD的患者（n = 39）和接受选择性NGD的患者（n = 37）。选择性NGD组中有18例患者从未需要插管，而19例患者在术后平均3天内确实需要插管。两组中，鼻胃管留置的平均时间均为4.7天。常规NGD组的呕吐发生率为2.5%，而选择性NGD组的呕吐发生率为51%。两组患者的肠功能恢复、恢复正常饮食及术后住院时间相似。选择性NGD组中不需要插管的患者术后住院时间较短。选择性NGD组中需要插管的患者有58%曾进行过大血管或腹膜后解剖手术。这些数据支持在普通外科患者中选择性使用NGD，而对于进行过大腹膜后或血管手术的患者则常规使用NGD。
