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目的:探讨中老年结直肠癌围手术期胃肠减压的必要性。方法:采用Mantel-Haenszel法对211篇文献中符合入选标准的6篇进行荟萃(Meta)分析,计算优势比(OR)。结果:入选6篇文献共计794例患者,其中观察组(未插胃管,N-NG)407例,对照组(插胃管,NG)387例。与NG组比较,N-NG组围手术期间总并发症降低14.4%(P=0.0002);首次排气,排便时间均较快(P=0.004,P=0.000);术后肺部感染、咽喉炎、发热症状分别降低15.85%,15.85%,12.02%(P=0.000,P=0.000,P=0.0006);住院时间及费用均有所降低(P=0.000,P=0.000),敏感性分析证实结论较为可靠。结论:中老年结直肠癌围手术期不行胃肠减压,不仅能够减少总并发症发生率、减少术后感染几率、缩短胃肠功能恢复时间,还能缩短住院时间,减少住院费用。
Objective: To explore the necessity of perioperative decompression of gastrointestinal in middle-aged and elderly patients with colorectal cancer. Methods: Mantel-Haenszel method was used to analyze Meta-analysis of 6 articles that meet the inclusion criteria in 211 articles to calculate odds ratio (OR). Results: A total of 794 patients were enrolled in the 6 articles, including 407 observation group (without gastric tube and N-NG) and 387 control group (gastric tube and NG). Compared with the NG group, the total complication rate decreased 14.4% (P = 0.0002) during the perioperative period in the N-NG group; the time of first excretion and defecation was faster (P = 0.004, P = 0.000); the postoperative pulmonary infection, The symptoms of inflammation and fever were decreased by 15.85%, 15.85% and 12.02%, respectively (P = 0.000, P = 0.000, P = 0.0006); hospitalization time and cost were decreased (P = 0.000, P = 0.000) The conclusion is more reliable. Conclusion: Perioperative decompression of colorectal cancer in the elderly can not only reduce the incidence of total complication, reduce the risk of postoperative infection, shorten the recovery time of gastrointestinal function, but also shorten the length of hospital stay and reduce the cost of hospitalization.