| Most of gastric cancer of eldly people have three features:found lately , highly malignant extent of cancer and followed many complications. operation is the main treat method. The key is the recovery postoperation. Fast-track surgery began at 1990. The researchs of it have ideal results in American,germany,denmark and other countrys. It's central idea is adopting a series of active measures to promote gastroenteric tract recovery,shorten length of stay,reduce the incidence rates of complications and reduce the expense of inpatient care postoperation through perioperative. This new clinical treat mode already widespread in eachsurgery. Although many reports in postcholecystectomy,posthepatectomy and others,there has few reports in postgastrectomy. This article has a retrospective analysis to clinical dates of 54 eldly patients with gastric cancer , to research the meanings of early arresting gastrointestinal decompression and early enteral nutrition postgastrectomy. 42 cases were male,12 cases were female,the ages were among 70-91,average was 78,the patients were divided into 2 groups , one group were arrested gastrointestinal decompression and given enteral nutrition on postoperative day 1,control group were arrested gastrointestinal decompression and given enteral nutrition after the flatus. There were no significance difference on sex,mean age and operation style(P>0.05). There were no significance difference on hypertension,coronary heart disease,chronic tracheitis,emphysema,diabetes and other preoperative complications (P>0.05). The observation indices include the flatus passing and defecation time,the length of hospital stay,the postoperative complications. 6 cases had abdominal distension after arrest gastrointestinal decompression in test group,5 cases relived by activity and stimulate enterokinesia drugs,1 case placed gastrointestinal decompression again who can not relief. In two groups,3 cases infection of incisional wound,healed by change dressings;2 cases pulmonary infection,confirmed by X-ray sternite and healed by antiinflammatory;2 cases anastomotic leakage,healed after 5-12 days. There was significance difference on the flatus passing time,the defecation time and unwell of pars laryngea phary(P<0.05). Thers was no significance difference on diarrhea, infection of incisional wound,pulmonary infection,anastomotic leakage and length of stay(P>0.05).Conclusion:Most of eldly patients with gastric cancer are tolerant with early arresting gastrointestinal decompression and early enteral nutrition,it will not increase the probability of anastomotic leakage but promote the recovery of intestinal tract fuction;It can increase activity time,promote enterokinesia,decrease the unwell of pars laryngea and pulmonary infection by early arresting gastrointestinal decompression;with regard to postgastrectomy patients,especially eldly patients , it suggests routine arresting gastrointestinal decompression. It is more beneficial to patient's recovery if there is no gastrointestinal decompression and early enteral nutrition。... |
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