胃造瘘技术在膀胱全切回肠代膀胱术后胃肠减压中作用.PDFVIP

·1194 · 南方医科大学学报（J South Med Univ ） 2012;32(8) 临床研究 胃造瘘技术在膀胱全切回肠代膀胱术后胃肠减压中的作用 徐 冉，蒋宏毅，赵晓昆，钟朝晖，吴洪涛，张 磊，侯 轶，任伟刚，朱 煊，李松超 中南大学湘雅二医院泌尿外科，湖南 长沙 410011 摘要：目的探讨胃造瘘技术在膀胱全切回肠代膀胱手术中的应用及实际效果。方法回顾性分析2007 年3 月~2010 年2 月在中 南大学湘雅二医院行膀胱全切回肠代膀胱手术的两种胃肠减压方式（胃造瘘组48 例和经鼻留置胃管组50例）的患者资料，如胃 肠道功能恢复时间、手术相关并发症及住院时间等，通过统计学分析评价两种胃肠减压方式对患者术后恢复及并发症所带来的 影响，了解胃造瘘技术在该手术中的作用。结果两种术后胃肠减压方式在胃肠道恢复、胃肠道并发症、切口愈合及住院天数上 无明显差别，但术后肺部感染率胃造瘘组较经鼻留置胃管组为低，有统计学意义(P0.05)。结论胃造瘘技术成熟、安全、并发症 低；在高龄患者或有潜在术后呼吸系统并发症风险的患者中，可以采用胃造瘘方式来进行胃肠减压来降低肺部并发症的发生。 关键词：膀胱全切；胃肠减压；胃造瘘；回肠代膀胱 中图分类号：R694 文献标志码：A 文章编号：1673-4254（2012）08-1194-03 doi: 10.3969/j.issn. 1673-4254.2012.08.28 /kcms/detail/44.1627.R1108.020.html Application of tube gastrostomy in radical cystectomy with ileal conduit: a retrospective, comparative study XU Ran, JIANG Hongyi, ZHAO Xiaokun, ZHONG Zhaohui, WU Hongtao, ZHANG Lei, HOU Yi, REN Weigang, ZHU Xuan, LI Songchao Department of Urology, Second Xiangya Hospital of Central South University, Changsha 410011, China Abstract: Objective To evaluate the clinical results of tube gastrostomy in radical cystectomy and ileal conduit. Methods We retrospectively analyzed the data of 98 patients undergoing radical cystectomy and ileal conduit between March 2007 and February 2010. According to postoperative gastrointestinal decompression methods, the patients were divided into nasogastric decompression group (n=50) and tube gastrostomy group (n=48), and the gastrointestinal recovery time, surgical complications and hospital stay were compared between them. Results No statistical difference was found in gastrointestinal recovery time, hospital stay, or surgical complications between the two groups, but the incidence of pulmonary infection was significantly lower in tube gastrostomy group than in nasogastric deco