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目的:研究妇科腹腔镜术后拔管时间对患者术后胃肠功能与并发症发生率的影响。方法:140例患者根据疾病类型接受相应全麻下妇科腹腔镜手术,患者随机分为观察组和对照组,各70例。根据患者病情行相应腹腔镜手术,观察组患者拔尿管时间在术毕10~14 h内,对照组拔尿管时间在术后24 h以上。记录患者术中出血量及手术时间,术后记录患者的补液量、肠鸣音时间、首次肛门排气时间、首次排便时间以及典型并发症,比较组间差异。结果:(1)观察组患者术后首次排便时间、首次自行排尿时间、首次排气时间、肠鸣音恢复时间均明显短于对照组,t值分别为9.283、31.842、6.315、10.835,P<0.05。(2)两组患者术后不良反应发生率分别为31.4%、78.6%,组间比较,观察组明显低于对照组,差异有统计学意义,尤其是尿路刺激症、恶心、呕吐及腹胀,P<0.05。结论:10~14 h内拔管的患者术后胃肠道功能恢复得更快,相关并发症发生率也大大降低,临床宜在条件允许的情况下提早拔管,有利于患者恢复。
Objective: To study the effect of extubation time after gynecological laparoscopic surgery on postoperative gastrointestinal function and complication rate. Methods: One hundred and forty patients underwent gynecological laparoscopic surgery under general anesthesia according to the type of disease. The patients were randomly divided into observation group and control group, with 70 cases in each group. According to the patient’s condition corresponding laparoscopic surgery, the observation group of patients with catheter removal time within 10 ~ 14 h after surgery, control group pull catheter time 24 h after surgery. The patients’ blood loss and operation time were recorded. The patient’s rehydration volume, bowel sound time, first anal exhaust time, first defecation time and typical complications were recorded. The differences between groups were compared. Results: (1) The first postoperative defecation time, the first time of spontaneous urination, the first exhaust time and the recovery time of bowel sounds in the observation group were significantly shorter than those in the control group (t = 9.283,31.842,6.315,10.835, P < 0.05. (2) The incidence of postoperative adverse reactions in both groups were 31.4% and 78.6%, respectively. The observation group was significantly lower than the control group, the difference was statistically significant, especially urinary tract irritation, nausea, vomiting and abdominal distension , P <0.05. Conclusion: The patients with extubation within 10-14 h recovered their gastrointestinal function more quickly and the incidence of related complications was greatly reduced. It is advisable to extubate early if the conditions permit, which is good for patients to recover.