2种术后进食方案在上消化道内镜黏膜下剥离术患者的应用效果观察

目的 探讨上消化道内镜黏膜下剥离术后患者早期经口进食的应用效果及安全性。方法 采用随机数字表法纳入82例上消化道内镜黏膜下剥离术患者,对照组和观察组各41例,因观察组4例非医嘱出院而脱落,最终观察组37例,对照组41例,共收集病例78例。观察组患者术后给予早期经口进食方案：麻醉苏醒后10 min试饮水,术后2 h试进全流食,术后7 h进半流或无渣软食,7 d后向正常饮食过渡。对照组患者术后给予传统进食方案：麻醉苏醒后1 h试饮水,术后第2个24 h试进全流食,第3个24 h进半流或无渣软食,7 d后向正常饮食过渡。2组均配合术后用药,健康教育。比较2组间在术后腹痛、出血、感染、穿孔的发生率的差异。结果 观察组与对照组的并发症比较,差异无统计学意义（16% VS 22%,P=0.521）。结论 上消化道内镜黏膜下剥离术后患者早期经口进食,减少禁食、禁水时间,不会增加并发症的发生率,患者更易于接受,在临床应用中具有安全性。

Comparison of Two Postoperative Feeding Patterns in Patients after Endoscopic Submucosal Dissection

Objective To explore the effect and safety of early oral feeding following endoscopic submucosal dissection. Methods A total of 82 patients who underwent endoscopic submucosal dissection were randomly divided into control group and observation group, with 41 cases in each group and in the observation group, 4 patients discharged against medical advice thus there were only 37 cases. Early oral feeding was implemented in the observation group including drinking 10min after anesthesia recovery, full liquid diet 2 h after the surgery, soft diet 7 h after the surgery and normal diet 7 d after the surgery. Conventional feeding program was conducted in the control group including drinking 1h after anesthesia recovery, full liquid diet at second postoperative 24h, soft diet at third postoperative 24 h and normal diet 7 d after the surgery. Patient in the both groups took medications and received health education. Abdominal pain, bleeding, infection and the incidence of perforation in the two groups were compared. Results The comparison of complications in the two groups indicated no statistical significance (16% VS 22%,P=0.521). Conclusion Early oral feeding following endoscopic submucosal dissection is acceptable for patients since it shortens the fasting time after the surgery while no higher incidence of complications is found. It is safe in clinical practice.