Mosimann F, Cornu P
Department of Surgery, University Hospital (CHUV), Lausanne, Switzerland.
Eur J Surg. 1998 Jul;164(7):527-30; discussion 531-2. doi: 10.1080/110241598750005886.
To assess the effect of preoperative enemas on the recovery of peristalsis after non-colonic abdominal operations.
Prospective randomised trail.
University hospital, Switzerland.
116 adult patients (> 16 year old) about to undergo elective non-colonic abdominal operations under general anaesthaesia were considered.
Two groups were randomised to receive a one litre water and glycerine enema the day before operation (n = 53) or no preoperative intestinal preparation (n = 53).
Return of peristalsis after operation, assessed by auscultation of bowel sounds and time of the first spontaneous faeces. All participants were followed daily for 10 days or until discharge by the same observer.
110 patients gave informed consent, 6 refused to participate, and 4 had to be withdrawn after randomisation, leaving 106 for analysis. The patients without an enema recovered bowel sounds activity sooner (p = 0.02) and passed their first spontaneous faeces significantly earlier (p = 0.01). No subgroup of patients benefited from an enema.
Preoperative enemas delay rather than improve the return of normal peristalsis after surgery. We recommend this practice should be abandoned.
评估术前灌肠对非结肠腹部手术后肠蠕动恢复的影响。
前瞻性随机试验。
瑞士大学医院。
116例拟在全身麻醉下接受择期非结肠腹部手术的成年患者（年龄>16岁）。
两组患者被随机分为两组，一组在手术前一天接受1升水和甘油灌肠（n = 53），另一组不进行术前肠道准备（n = 53）。
术后肠蠕动恢复情况，通过听诊肠鸣音和首次自主排便时间进行评估。所有参与者由同一名观察者每天随访10天或直至出院。
110例患者签署知情同意书，6例拒绝参与，4例在随机分组后不得不退出，最终106例纳入分析。未接受灌肠的患者肠鸣音恢复更快（p = 0.02），首次自主排便时间显著更早（p = 0.01）。没有亚组患者从灌肠中获益。
术前灌肠会延迟而非改善术后正常肠蠕动的恢复。我们建议应摒弃这种做法。
