Effect of different clinical interventions for gastric tube in patients undergoing gastrointestinal operations on the risk of postoperative complications and recovery of gastrointestinal tract / 实用医学杂志

ABSTRACT

Objective To assess the effect of different clinical interventions for gastric tube in patients undergoing gastrointestinal operations for measuring the risk of postoperative complications and recovery of gastrointestinal tract. Methods A total of 148 patients undergoing gastrointestinal operations were recruited and divided into Group A, B, C and D, with 37 cases in each group. All patients underwent perioperative management based on the concept of rapid rehabilitation surgery. Group A were not indwelled with gastric tube with routine method. Group B were indwelled with gastric tube with routine method and got nasogastric extubation 5 min before tracheal extubation. Group C were indwelled gastric tube with routine method and got nasogastric extubation 6 h after fully conscious of anesthesia. Group D indwell gastric tube with routine method and got nasogastric extubation 12 h after fully conscious of anesthesia. The parameters including time of the first passing of flatus, defecation and resuming peristaltic sound after operation between the groups were compared. Vasoactive Intestinal Peptide (VIP), Motilin (MTL) and Glucagon (GLU)before the operation, and at the 1st, 3rd and 7th day after operation were measured by radioimmunoassay. Results Time of the first passing of flatus, defecation and resuming peristaltic sound after operation showed a rising trend from Group A to Group D. The difference in time of the first passing of flatus was not significant (P>0.05), time of defecation and resuming peristaltic sound after operation in Group A were significantly shorter (P0.05). VIP in Group A at the 3rd day after operation was significantly lower than those in other 3 groups , with the increasing of time for indwelling tubes. VIP showed a rising trend. MTL showed a decreasing trend with the increasing of time for indwelling tubes at 3rd and 7th day after operation. GLU in Group A was the highest (P0.05). Nausea and vomiting, anastomotic fistula, intestinal obstruction, abdominal distension in 4 groups showed no significant differences (P>0.05). Conclusion Avoidance of gastric tube in gastrointestinal operations can benefit the postoperative recovery of gastrointestinal tract , reduce pharyngeal discomforts and pulmonary infections. For patients with indwelled gastric tube, the time for indwelling tubes should be shorten, in order to speed up the recovery process and improve the safety of the patients.