冠心病介入手术前不同饮食护理对围术期患者迷走神经反射的影响

Effects of Different Diet Nursing Methods Before Interventional Operation for Coronary Heart Disease on Perioperative Patients' Vagus Reflex

目的探讨冠心病介入手术前不同饮食护理方法对围术期患者迷走神经反射的影响。方法按随机数字表法将130例患者分为对照组67例和观察组63例,对照组患者采取术前12h限制饮食及水量、术前3～4h禁食禁饮、术后1h进食半流质及水的饮食护理方法,观察组患者采取术前无需禁食、禁饮、按常规进食的护理方法,观察两组患者术中、术后迷走神经反射的发生率。结果对照组67例患者中有18例出现轻重不同的迷走神经反射现象,其中4例出现严重的心律失常、血压下降、恶心呕吐等;观察组63例患者中,只有2例血压偏低,其中1例伴有心率减慢、心悸、出虚汗,其余患者感觉良好,生命体征、心律正常,两组比较,差异有统计学意义(P<0.05)。结论冠心病介入手术前采用无需禁食、禁饮按常规进食的护理方法,既可预防因血容量不足所致的迷走神经反射,又可避免空腔器官过度回缩而引发的胃肠道等不良反应,减轻了患者的痛苦,缩短了住院时间,降低了医疗费用,提高了手术和护理质量。

Objective To discuss the effects of different diet nursing methods before interventional operation for coronary heart disease on perioperative patients＇ vagus reflex. Methods A total of 130 patients were randomly divided into control group（n=67）and experiment group（n=63）. The control group underwent diet and water restriction 12 hours before the operation,absolute fasting 3 or 4 hours before the operation and dietary nursing of semi-liquid food and water 1 hour after the operation. While, the control group take the method of conventional feeding. The vagus reflex incidence was osbserved in both groups intra operation and post operation. Results Totally 18 patients were observed with different levels of the vagus reflex of the control group,among whom four patients had serious arrhythmia,blood pressure drop, nausea, vomiting and other phenomena. However,only two patients in the experimental group were observed with hypotension, of whom one patient had decreased heart rate, palpitation, sweating out. The rest in the exper- imental group all felt well and had normal vital signs. Comparisons between the two groups showed significant difference between the two groups（P〈0.05）. Conclusion The nursing method of conventional feeding without absolute fasting before interventional operation for coronary heart dsease can prevent the occurrence of vagus reflex caused by inadequate blood volume, reduce the pain and medical cost, shorten the hospitalization time and improve the quality of the operation and nursing.