| 韩蔷,冯金华,许瑞华.缩短禁食时间在腹腔镜胆囊切除病人围手术期管理中的应用效果评价[J].安徽医药,2019,23(4):768-770. |
| 缩短禁食时间在腹腔镜胆囊切除病人围手术期管理中的应用效果评价 |
| Effects of shortening preoperative fasting time and postoperative early food-taking on patients underwent laparoscopic cholecystectomy |
| 投稿时间：2018-01-13 |
| DOI： |
| 中文关键词: 胆囊切除术,腹腔镜 围手术期医护 禁食 进食 治疗结果 |
| 英文关键词: Cholecystectomy,laparoscopic Perioperative care Fasting Eating Treatment outcome |
| 基金项目:四川大学华西医院“学科卓越发展1-3-5工程”资助项目(ZY2016204) ◇临床医学◇ 缩短禁食时间在腹腔镜胆囊切除病人围手术期管理中的应用效果评价 韩蔷,冯金华,许瑞华 (四川大学华西医院胆道外科,四川 成都 610041) |
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| 中文摘要: |
| 目的 探讨腹腔镜胆囊切除(LC)病人术前禁食时间缩短及术后早期经口进食对病人术后康复效果的安全性及有效性。方法 回顾性分析四川大学华西医院2017年10—12月进行LC的141例病例资料(试验组)及该院2017年7—9月135例LC病例资料(对照组),试验组病人采用术前禁食时间缩短和术后早期进食的策略,即术前2 h口服该院营养科配置的复合碳水化合物制剂200 mL,麻醉清醒后口服温开水100 mL,术后4 h口服复合碳水化合物营养制剂200 mL；对照组病人按照术前8 h禁食,6 h禁饮,术后12 h进水的围术期常规管理进行,对比分析两组病人术后12 h饥饿、口渴、咽喉肿痛、恶心、呕吐、腹痛、腹胀等不良反应发生率,并探讨两组病人肠鸣音恢复情况、术后首次排气时间、住院时间等康复指标的差异。结果 两组病人的手术麻醉时间及手术时长比较,差异无统计学意义(P＞0.05),试验组病人术后饥饿、口渴、咽喉肿痛的发生率均低于对照组(χ2=4.046、3.456、81.480,P=0.034、0.045、0.001),试验组术后12 h的肠鸣音恢复率早于对照组(55.32%比14.81%,P＜0.05)。结论 LC病人术前禁食时间缩短及术后早期经口进食是安全可行的,能有效降低病人的不良反应,改善舒适度,促进术后早期康复,为加速康复理念下缩短病人围手术期禁食禁饮时间提供了一定的证据支持。 |
| 英文摘要: |
| Objective To evaluate the safety and efficacy in reducing preoperative fasting time and early postoperative oral feeding in patients who underwent laparoscopic cholecystectomy (LC).Methods One hundred and forty-one patients who underwent laparoscopic cholecystectomy from October to December 2017 (test group) and 135 patients from July to September 2017 (control group) in West China Hospital of Sichuan University were analyzed retrospectively.Patients in test group were treated with a shortened preoperative fasting time and early postoperative feeding strategy,that is,200 mL oral compound carbohydrate nutrient 2 hours before operation and 100 mL warm water 2 hours after operation,then take 200 mL oral compound carbohydrate nutrient 4 hours after operation.The patients in control group were underwent the routine perioperative management of fasting 8 hours before operation,fasting 6 hours after operation,and water intake 12 hours after operation.The incidence of adverse reactions such as hunger,thirst,sore throat,nausea,vomiting,abdominal pain and abdominal distension 12 hours after operation was compared and analyzed between the two groups,and the differences in recovery of intestinal sounds,first postoperative exhaust time,hospitalization time and other rehabilitation indexes of the two groups were discussed. Results Anesthesia time and operation time have no significant difference between test group and control group (P＞0.05).The rates of thirst,hunger and sore throat in patients of test group were significantly lower than that in the control group (χ2=4.046,3.456,1.480,P=0.034,0.045,0.001).The recovery rates of postoperative bowel sounds 12 hours after the surgery in test group was higher than control group (55.32% vs. 14.81%,P＜0.05).Conclusion It is safe and feasible for laparoscopic cholecystectomy patients to shorten preoperative fasting time and early postoperative oral feeding,which can effectively reduce adverse reactions of patients,improve comfort,and promote early postoperative rehabilitation,providing certain evidence support for shortening perioperative fasting and abstinence time of patients under the concept of accelerating rehabilitation. |
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