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頁籤選單縮合
題 名 | Early Enteral Feeding after Colorectal Surgery: Preliminary Hospital Experience=大腸直腸手術術後早期腸道進食:高雄榮總的經驗 |
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作 者 | 陳禹勳; 王瑞和; 金台明; 張敏琪; 許詔文; | 書刊名 | 中華民國大腸直腸外科醫學會雜誌 |
卷 期 | 26:4 2015.12[民104.12] |
頁 次 | 頁157-162 |
分類號 | 416.245 |
關鍵詞 | 大腸直腸癌; 術後早期進食; 腸胃道功能; 預後; Colorectal cancer; Early enteral feeding; Gastrointestinal function; Prognosis; |
語 文 | 英文(English) |
中文摘要 | 目的:此篇研究的目的為探討是否早期腸道進食對我們醫院的患者是否有同樣的好處。方法:從2014年三月至2015年三月間,對於接受大腸直腸手術且有完整病歷記錄的病患進行前瞻性的回溯分析。病人分為兩組,一組為早期進食組,另一組為傳統禁食組。早期進食組依照早期恢復的治療流程進行而傳統組則照一般治療的方式。主要終點為第一次排便的時間而次要終點為吻合處滲漏。結果:共200位病患被收錄,其中190位進入最後分析(兩組各95位患者)。平均排氣時間為早期進食組的2.76天(1到10天)比上傳統組的4.07天(3到7天);平均第一次排便的時間則為4.04天(2到13天)比上6.05天(3到19天)。兩者統計學上皆有意義(p < 0.05)。另外,平均恢復至攝取固體食物的時間為早期進食組的4.44天(3到17天)比上傳統組的6.72天(4到21天),同樣p值 < 0.05。另外,傳統組的患者有一位發生吻合處滲漏的情形(p=0.316)。結論:早期進食對於大腸直腸術後患者的恢復扮演了一個重要的角色,可以讓患者提早恢復腸道的功能並且不會增加術後併發症的機率。未來我們將會考慮對患者施行的更積極且嚴謹的治療流程(目前可能為多數西方國家標準的術後恢復流程)。 |
英文摘要 | Purpose. The aim of this study was to determinate whether early postoperative enteral feeding is suitable for patients undergoing colorectal surgery in our hospital. Methods. A retrospective review was performed of a prospectively collated database of patients undergoing colorectal surgery in our hospital between March 2014 and March 2015. Patients were divided into two groups, early enteral feeding and traditional "nil by mouth". The early feeding group was treated by a modified fast track protocol and the traditional group was treated as per usual practice. Primary end point was time to first defecation; secondary end point was anastomosis leakage. Results. Of the 200 enrolled patients, 190 patients were analyzed (95/ group). Mean time to flatus was 2.76 (1 to 10) days in the modified fast track group and 4.07 (3 to 7) days in the traditional group; mean time to first defecation was 4.04 (2 to 13) days and 6.05 (3 to 19) days, respectively. These results were statistically significant (p < 0.05). Time to solid diet in the modified fast track group was 4.44 (3 to 17) days compared with 6.72 (4 to 21) days in the traditional group (p < 0.05). There was one case of anastomic leakage in the traditional group (p=0.316). Conclusion. Early enteral feeding plays an important role in the recovery of patients after colorectal surgery and can improve gastrointestinal function without increasing postoperative complications. More aggressive patient treatment protocols with strict application should be considered in the future. |
本系統中英文摘要資訊取自各篇刊載內容。