在成人外科手术中，造口翻修后早期喂养与传统方案的效果对比。

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP Pub Date : 2024-10-01 DOI:10.29271/jcpsp.2024.10.1158

Sajid Ali, Faheem Khan, Saman Hafeez, Zaka Ullah Jan, Mian Tauseef Uddin

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引用次数: 0

摘要

研究目的比较成人手术中造口术后早期喂养和常规喂养方案的有效性：随机对照试验。研究地点和时间：巴基斯坦马尔丹区总部医院普外科，2020年1月至2022年7月：本研究共纳入了 72 名在手术室接受造口翻转术的患者。采用排除标准后，68 名患者被随机分为两组，每组 34 人。A 组患者可在术后 24 小时内口服流质食物，而 B 组患者则可在 72 至 96 小时后，即鼻胃管拔除且肠道功能恢复后口服流质食物。从术后回肠梗阻、吻合口渗漏、伤口感染和住院时间等方面对疗效、安全性和耐受性进行评估：研究对象的年龄范围为 18 至 43 岁，平均（±SD）为 31.602 ± 6.75 岁。其中男性 41 人（60.29%），女性 27 人（39.71%），两组中均以男性为主。结果明显有利于 A 组，28 名（82.35%）患者没有出现术后回肠梗阻，而 B 组只有 17 名（50%）患者出现回肠梗阻（P = 0.004）。与 B 组相比，A 组的伤口愈合情况也明显更好，30 例（88.23%）患者没有发生伤口感染，而 B 组则有 21 例（61.76%）（P = 0.001）。两组在吻合口漏方面没有差异。A 组患者的住院时间（3.117 ± 0.87 天）明显短于 B 组（5.617 ± 1.43 天）（p = 0.001）：结论：在成人外科手术中，造口翻转术后早期喂养是有效的，可最大限度地减少术后并发症，缩短住院时间：吻合口漏早期喂养住院时间造口翻转术

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Effectiveness of Early Feeding versus Conventional Protocol after Stoma Reversal in Adult Surgical Practices.

Objective: To compare the effectiveness of early feeding and conventional feeding protocol after stoma reversal in adult surgical practices.

Study design: Randomised controlled trial. Place and Duration of the Study: Department of General Surgery, District Headquarters Hospital Mardan, Pakistan, from January 2020 to July 2022.

Methodology: A total of 72 patients enrolled in the surgical unit for stoma reversal were included in this study. After applying the exclusion criteria, 68 patients were randomised in two equal groups of 34 patients each. In Group A, patients were allowed oral liquid feed within 24 hours after surgery while in Group B oral liquid feed was allowed after 72 to 96 hours when the nasogastric tube was removed and bowel functions were returned. Efficacy, safety, and tolerability were evaluated from outcomes such as postoperative ileus, anastomosis leakage, infection of the wound, and length of hospital stay.

Results: The age range in this study was from 18 to 43 years with mean ± SD of 31.602 ± 6.75 years. There were 41 (60.29%) males while 27 (39.71%) females in this study and the male population was dominant in both groups. The results were significantly in favour of Group A, where 28 (82.35%) patients did not have postoperative ileus compared to 17 (50%) patients in Group B (p = 0.004). Wound healing was also significantly better in Group A compared to Group B, where 30 (88.23%) patients had no wound infection compared to 21 (61.76%), respectively (p = 0.001). There was no difference between both groups regarding anastomotic leakage. Length of hospital stay was significantly shorter in Group A (3.117 ± 0.87 days) compared to Group B (5.617 ± 1.43 days) (p = 0.001).

Conclusion: Early feeding after stoma reversal is effective, minimises the postoperative complications, and leads to shortening of hospital stay in adult surgical practices.

Key words: Anastomosis leakage, Early feeding, Length of hospital stay, Stoma reversal.

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Journal of the College of Physicians and Surgeons--Pakistan : JCPSP

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