探讨口腔癌根治同期修复重建术应用胃肠减压的临床效果。

选择中山大学附属口腔医院口腔颌面外科行口腔癌根治同期修复重建术患者230例。2010年12月至2013年2月住院手术患者115例为非胃肠减压组，术后未行胃肠减压，于术后第1天予留置胃管并进行鼻饲流质。2013年3月至2014年8月住院手术患者115例为持续胃肠减压组，于术中进行留置胃管，术后即予持续胃肠减压，术后第1天予鼻饲流质。统计持续胃肠减压组与非胃肠减压组术后恶心呃逆、呕吐、返流误吸及吸入性肺炎的发生率，采用卡方检验或Fisher确切概率法比较分析即刻持续胃肠减压在口腔癌根治同期修复重建患者中的作用。

非胃肠减压组术后出现恶心呃逆17例（14.78%）、呕吐26例（22.61%）、吸入性肺炎2例（1.74%）。持续胃肠减压组术后出现恶心呃逆5例（4.35%）、呕吐2例（1.74%），未出现吸入性肺炎。持续胃肠减压组采用即刻持续胃肠减压方法后，其术后呕吐（χ² = 23.410，P = 0.003），恶心呃逆（χ² = 7.238，P = 0.008）与胃肠反应发生率（χ² = 33.120，P = 0.005）均低于非胃肠减压组，差异有统计学意义。

口腔癌根治和修复重建手术患者术后给予持续胃肠减压可减少患者术后恶心呃逆、呕吐的发生，预防术后创口感染，利于皮瓣成活，并可通过引流液性质和引流量动态观察患者术后口内创口渗血情况，及时发现病情的变化，有利于患者安全。

To investigate the clinical efficacy of gastro-intestinal decompression in oral cancer patients who undergo resection and reconstruction surgery.

Two hundred and thirty oral cancer patients undergoing resection and reconstruction surgery were selected from department of oral and maxillofacial surgery, Hospital of Stomatology, Sun Yat-sen University. The patients were divided into two groups: Control group (n = 115) , and the experimental group (n = 115) . Patients hospitalized from December 2010 to February 2013 were included into the control group, and patients hospitalized from March 2013 to August 2014 were included into the experimental group. The experimental group was indwelled gastric tube at the onset after operation and gave a postoperative continuous gastro-intestinal decompression. The patients were given nasal feeding on the first day after surgery. Comparing to the experimental group, patients in the control group did not undergo decompression during the surgery. And the patients were indwelled gastric tube and gave nasal feeding on the first day after surgery. The incidence rates of vomiting, nausea and gastrointestinal reaction were compared between the control group and the experimental group by Chi-square test and Fish exact probability method.

In the control group, 17 patients were suffered from postoperative nausea and hiccups (the incidence rate is 14.78%) , 26 patients were suffered from vomiting (the incidence rate is 22.61%) , and 2 patients were suffered from aspiration pneumonia (the incidence rate is 4.35%) . In the experimental group, there were 5 patients suffering from hiccups and nausea (the incidence rate is 1.74%) , and 2 patients suffering from vomiting (the incidence rate is 1.74%) . In addition, aspiration pneumonia was not reported in the control group. The incidence of vomiting (χ² = 23.410, P = 0.003) , nausea and hiccups (χ² = 7.238, P = 0.008) as well as gastrointestinal reaction (χ² = 33.120, P = 0.005) of the experimental group were markedly lower than that in the control group.

Giving continuous decompression to the oral cancer patients after resection and reconstruction surgery can reduce postoperative nausea, hiccups and vomiting, which prevents postoperative wound infection and benefit to flap survival. Moreover, changes in condition of patients can be detected through observing the nature of drainage fluid, which is helpful for patient safety.