肠道手术患者早期经口进食可获益

芝加哥——基于对100例患者的研究数据，共计有80%的肠切除手术患者可耐受术后一天早期进流食。

埃及苏伊士运河大学的Mohamed E. Shams博士在美国外科医师协会(ACS)年会上指出：“早期经口进食是快通道手术的重要组成部分，可增强术后恢复能力”，但在接受急诊肠切除手术的患者中，经口进食一般会推迟到肠梗阻解除。

Shams博士及其同事将100例接受小肠或大肠切除术的成人患者随机分为两组。早期进食组的50例患者在术后第1天经口进流食，晚期进食组的50例患者在肠梗阻解除之后经口进食。

结果显示，早期进食组有80%的患者可耐受早期经口进食。并且其平均排气(0.8天 vs. 3.2天)和排便时间(1.2天 vs. 4.4天)显著早于晚期进食组。术后监测显示，早期进食组和晚期进食组分别有4例和10例患者发生胸部感染，分别有12例和15例患者发生伤口感染。早期进食组无患者发生腹部切口裂开，晚期进食组发生3例腹部切口裂开。

研究者总结认为，对于多数急诊肠道手术患者，术后早期经口进食是安全和可以耐受的，不伴并发症和死亡风险增高，并且对缩短住院时间有利。

Shams博士披露无相关利益冲突。

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By: HEIDI SPLETE, Internal Medicine News Digital Network

CHICAGO – A total of 80% of bowel resection patients tolerated early fluids one day after surgery, based on data from 100 patients.

"Early oral feeding is an important part of fast-track surgery, which enhances recovery after surgery," but feeding in patients undergoing emergency bowel resection is often delayed until the resolution of ileus, Dr. Mohamed E. Shams of Suez Canal University in Ismailia, Egypt, said at the annual clinical congress of the American College of Surgeons.

Dr. Shams and colleagues randomized 100 adults who underwent small or large bowel resection into two groups. The early group comprised 50 patients who received fluid oral feedings on the first day after surgery. The late group comprised 50 patients who received oral feedings after the resolution of ileus.

Overall, 80% of patients in the early group tolerated the early oral feeding. In addition, patients in the early group averaged a significantly shorter time than did the late group to the passage of flatus (3.2 days vs. 0.8 days, respectively), and stool (4.4 days vs. 1.2 days, respectively).

Postoperative monitoring showed that the chest infections occurred in four patients in the early feeding group compared with 10 patients in the late feeding group, while wound infections occurred in 12 patients in the early group and 15 patients in the late group, Dr. Shams said. No incidents of a burst abdomen occurred in the early group, and three incidents occurred in the late group.

"Early oral feeding after emergency intestinal surgery is safe and well tolerated by the majority of patients, without an increase in mortality and morbidity risk," said Dr. Shams. "It also has a positive impact on reduction in hospital stay," he said.

The findings were limited by the small number of patients, but the results suggest that a majority of patients undergoing emergency intestinal surgery can benefit from early feeding, Dr. Shams noted.

Dr. Shams had no financial conflicts to disclose.

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