小儿术前饮液对Hct、BS和血气分析的影响

On the benefit of oral liquid drinking to homeostasisin pediatric patients

目的研究小儿术前饮液对机体内环境的稳定作用。方法５３例患儿随机分两组，实验组（ｎ＝２９），术前１日晚餐后，自由饮牛奶、果汁饮料至麻醉前４～５ｈ，之后饮水至麻醉前２ｈ。对照组（ｎ＝２４）常规禁饮食。比较两组血糖（ＢＳ）、红细胞压积（Ｈｃｔ）、血酮体以及血气分析、胃液量等。结果实验组ＢＳ、ＰＣＯ２、ＢＥ和ＨＣＯ３－高于对照组、Ｈｃｔ低于对照组，均有统计学意义。对照组中分别有４例发生低血糖，２例代谢性酸中毒，５例患儿血酮体阳性，而实验组仅１例低血糖，１例血酮体阳性。实验组和对照组胃液量分别为（０．５５±０．３４）ｍｌｋｇ－１和（０．５８±０．４２）ｍｌｋｇ－１。结论小儿术前饮液，可避免或改善常规术前禁饮食引起的脱水、低血糖及代谢性酸中毒等内环境变化。

Objective To observe the effects of preoperative oral liquid drinking on the homeostasis in pediatric patients. Methods 53 cases were divided into two groups. For the study group(n=29), milk and fruit juice drinking was permitted until 4 or 5 h before anesthesia, and then only water drinking was allowed until 2 h prior to anesthesia after the last supper. The quantity of oral liquids averaged 1083±471 ml·kg-1, and fasting time averaged 368±14 h. The control group(n=24) followed the routine preoperative fasting orders, with fasting time averaging 1337±14 h. Then the two groups blood sugar, hematocrit, blood gas analysis and gastric fluid volume were compared. Result Blood sugar, PCO2 、BE and HCO-3 were significantly higher,and hematocrit was significantly lower in the study group than those in the control group, and hypoglycemia, metablic acidosis and ketonemia occurred respectively in 4, 2 and 5 patients. However, only one case of hypoglycemia and one case of ketonemia were found in the study group. There was no significant difference in gastric fluid volume between the study group (005±134 ml·kg-1). Conclusions The pediatric patients with preoperative oral liquid drinking can keep from or alleviate the dehydration, hypoglycemia, metabolic acidosis and ketonemia etc. resulting from the routine fasting, with no increase of aspiration 