禁食禁水时间对妇科腹腔镜手术患者不良反应的影响

Effect of actual fasting and banned water time on the adverse reactions of patients before gynecological laparoscopic operation

目的：探讨妇科腹腔镜手术患者不同禁食禁水时间对不良反应的影响。方法选取2011年1月-2012年12月进行妇科腹腔镜手术的400例患者为研究对象。按照不同禁食禁水时间随机分为4组，每组各100例。常规1组患者采用传统术前12 h禁食，6 h禁水方法；常规2组采用术前10h禁食，4h禁水法；常规3组采用术前8h禁食，3h禁水法；改良组采用术前6h禁食，2h禁水法。术前1 h采用医院用焦虑亚量表[ HAD（ a）]和抑郁亚量表[ HAD（ d）]比较4组患者术前焦虑抑郁程度，并比较术前术中胃液量、术后24 h恶心呕吐情况。结果4组患者术前、术中胃液量比较及术后恶心呕吐得分比较差异均无统计学意义（P＞0．05）；改良组患者HAD（a）评分为（8．37±1．65）分，HAD（d）评分为（9．01±1．87）分，均低于其他3组[HAD（a）评分分别为（14．52±2．57），（12．34±2．18），（10．26±1．76）分；HAD（d）评分分别为（14．59±2．69），（12．02±2．11），（10．97±1．77）分]，差异均有统计学意义（F值分别为4．912，4．160；P＜0．05）。改良组患者术前饥饿、口渴程度，均低于其他3组，差异均有统计学意义（Z值分别为26．247，18．431；P＜0．01）。结论妇科腹腔镜手术患者在术前6 h禁食，2 h禁水可有效控制术前术中胃液量，同时对缓解患者焦虑抑郁情绪及饥饿口渴程度有积极的作用。

Objective To investigation and analysis the effect of actual fasting and banned water time on the adverse reactions of patients before gynecological laparoscopic operation .Methods Choose 400 patients for the study who were treated with gynecological laparoscopic surgery in our hospital between January 2011 to December 2012, they were randomly divided into four groups the conventional 1,2,3 and the improved group with 100 cases in each group .The conventional group 1 used traditional method of fasting 12 h, banned water 6 h;the conventional group 2 used the method of fasting 10 h, banned water 4 h;the conventional group 3 used the method of fasting 8 h, banned water 3 h;the improved group used the method of fasting 6 h, banned water 2 h.The Anxiety and Scale （ HAD-a） and Depression and Scale （ HAD-d） were survey 1 hour before and after the operation .And the changes of patients ’ preoperative and intraoperative gastric volume , nausea and vomiting with 24 hours after operation were compared among the 4 groups.Results The changes of patients ’ preoperative and intraoperative gastric volume, nausea and vomiting before surgery had no significant difference （P〉0.05）. The scores of HAD-a and HAD-d for the improved group were （8.37 ±1.65） and （9.01 ±1.87）, which were significantly than the other 3 groups[the scores of HAD-a （14.52 ±2.57）, （12.34 ±2.18） and （10.26 ± 1.76）;the scores of HAD-d （14.59 ±2.69）, （12.02 ±2.11） and （10.97 ±1.77）].And the differences were statistically significant （F=4.912, 4.160, respectively;P〈0.05）.The degree of hunger and thirst was significantly lower in the improved group than that in the other groups （Z=26.247, 18.431, respectively;P〈0.01）.Conclusions Laparoscopic surgery patients with fasting 6h, banned water 2h can effectively control the amount of preoperative succus gastricus volume , while it also have a positive effect on alleviating the levels of anxiety and depression , hunger and thirst .