泌尿外科全麻腹腔镜手术患者术后早期进食的探讨

Research on food intake in early stage of postoperative period in patients with laparoscopic surgery performed under general anesthesia in department of urinary surgery

目的探讨泌尿外科腹腔镜手术患者全麻后早期进食对机体恢复的影响。方法将全麻腹腔镜手术后患者215例列为对照组,2012年6—10月全麻腹腔镜手术后患者221例列为观察组,对照组患者术后肛门排气后开始进食流质;观察组患者术后在意识完全清醒下由护理人员现场指导饮用30 mL温开水,若无误吸或呛咳即可进食流质。比较2组术后胃肠道功能恢复指标。结果观察组较对照组患者禁食时间显著缩短(P<0.05),误吸发生率与对照组无差异(P>0.05);观察组患者口渴、饥饿、胃不适等发生率显著低于对照组(P<0.05);观察组首次进食前外周血糖值高于对照组(P<0.05);观察组患者术后肛门排气时间与对照组比较均提前(P<0.05)。结论泌尿外科全麻腹腔镜手术患者术后在意识清醒且吞咽功能恢复的前提下早期进食能减轻患者术后口渴、胃部不适等症状,有利于肠道功能恢复和术后康复。

Objective To explore the influence of food intake in early stage of postoperative period on rehabilitation of patients with laparoscopic surgery performed under general anesthesia in department of urinary surgery.Methods 215 patients with laparoscopic surgery performed under general anesthesia from January to May in 2012 were designed as control group,while 221 patients with laparoscopic surgery performed under general anesthesia from June to October in 2012 were designed as observational group.The patients in the control group were able to have liquid food when the passage of gas by anus appeared;the patients in the observation group were able to drink 30 mL of warm water under the guidance of nurses when they had clear consciousness,and if there was no aspiration or bucking,the patients were allowed to have liquid food.Indexes on rehabilitation of gastrointestinal function were compared between two groups.Results Duration of fasting in the observation group was significantly shorter than that in the control group（P〈0.05）,while the incidence rate of aspiration showed no significant difference between two groups（P〈0.05）;the incidence rate of complications such as thirst,hanger and gastric discomfort in the observation group was lower than that in the control group（P〈0.05）,the level of peripheral blood glucose before the primary food intake was higher than that in the control group（P〈0.05）,and the duration of passage of gas by anus in postoperative period was shorter than that in the control group（P〈0.05）.Conclusion Patients with laparoscopic surgery performed under general anesthesia are allowed to take food in the early stage of postoperative period when they have clear consciousness and good gastrointestinal function.These measures can alleviate the sense of thirst and reduce the adverse syndromes such as gastric discomfort,so it is conducive to rehabilitation of gastrointestinal function and postoperative rehabilitation.