Pearl M L, Valea F A, Fischer M, Mahler L, Chalas E
Department of Obstetrics, Gynecology and Reproductive Medicine, State University of New York at Stony Brook, USA.
Obstet Gynecol. 1998 Jul;92(1):94-7. doi: 10.1016/s0029-7844(98)00114-8.
To evaluate the safety and efficacy of early oral feeding after intra-abdominal surgery in gynecologic oncology patients.
During a 1-year period, 200 gynecologic oncology patients undergoing intra-abdominal surgery were enrolled in a randomized controlled trial of early compared with traditional oral postoperative feeding. Patients allocated to early postoperative oral feeding began a clear liquid diet on the first postoperative day and then advanced to a regular diet as tolerated. Patients allocated to traditional postoperative oral feeding received nothing by mouth until return of bowel function (defined as the passage of flatus in the absence of vomiting or abdominal distention), then began a clear liquid diet, and advanced to a regular diet as tolerated.
Age, case distribution, surgery length, blood loss, and first passage of flatus were similar in the early and traditional feeding groups. Significantly more patients in the early group developed nausea. Despite this, the incidence of vomiting, abdominal distention, incidence and duration of nasogastric tube use, and percentage of patients who tolerated clear liquid and regular diets on the first attempt were comparable in both groups. Time to development of bowel sounds, time to initiation of clear liquid and regular diets, and hospital stay were significantly longer in the traditional group. Major complications (eg, pneumonia, atelectasis, and wound complications) and febrile morbidity occurred equally in both groups. There were no known anastamotic complications or aspirations in either group. Postoperative changes in hematologic indices and electrolytes were comparable in both groups.
Early postoperative feeding in gynecologic oncology patients undergoing intra-abdominal surgery is safe and well tolerated.
评估妇科肿瘤患者腹部手术后早期经口进食的安全性和有效性。
在1年期间，200例行腹部手术的妇科肿瘤患者被纳入一项关于早期与传统术后经口进食的随机对照试验。分配至早期术后经口进食组的患者在术后第1天开始进清流食，然后根据耐受情况逐渐过渡到常规饮食。分配至传统术后经口进食组的患者在肠道功能恢复之前（定义为在无呕吐或腹胀的情况下有排气）禁食，然后开始进清流食，并根据耐受情况逐渐过渡到常规饮食。
早期进食组和传统进食组在年龄、病例分布、手术时长、失血量和首次排气方面相似，但早期进食组出现恶心症状的患者明显更多。尽管如此，两组在呕吐、腹胀发生率、鼻胃管使用的发生率和持续时间以及首次尝试时耐受清流食和常规饮食患者比例方面相当。传统组肠鸣音出现时间、开始进清流食和常规饮食的时间以及住院时间明显更长。两组的主要并发症（如肺炎、肺不张和伤口并发症）和发热性疾病发生率相同。两组均未出现已知吻合口并发症或误吸情况。两组术后血液学指标和电解质变化相当。
接受腹部手术的妇科肿瘤患者术后早期进食安全且耐受性良好。
