颈椎全麻术后首次饮食时间研究

Study for first time of eating for patients after cervical general anesthesia

目的 探讨颈椎全麻术后患者首次饮水、进食的适宜时间。方法 选择2011年1月-2013年12月在我科行颈椎手术的829例全麻术后患者作为研究对象,排除上颈髓损伤、生命体征不稳定、术后2h内出现恶心呕吐症状者,以入院单双号随机分为观察组416人、对照组413人。观察组术后30min,患者意识清醒,即可饮用少于50ml温凉开水或盐水,术后2h进流质或半流质饮食;对照组于术后6h进饮食。分别于术后2h、5h评估两组患者口渴、饥饿、咽喉不适、恶心、呕吐、腹胀等不适情况,餐后2h恶心、呕吐及腹胀的发生率,以及进饮食时误吸的发生率,并进行比较。结果 术后2h口渴、咽喉不适者对照组高于观察组（P〈0.01）;术后5h口渴、咽喉不适、饥饿感对照组较术后2h在者和程度上明显增加,观察组人数减少,两组比较,差异有显著意义;餐后2h对照组腹胀者显著高于观察组,差异有显著意义（P〈0.01）;两组患者均未发生误吸现象。结论 颈椎全麻术后,在患者完全清醒的情况下,提早进饮食是安全、可行的,有利于术后患者胃肠功能恢复,并能增加患者术后的舒适感。

Objective To study the suitable first time for eating and drink for patients after cervical general anesthesia. Method 829 hospitalized patients with general anesthesia for cervical surgery from January 2011 to December 2013 in our hospital were selected for the study. Patients with such symptom, such as upper cervical spinal cord injury, unstable vital signs, vomiting and nausea 2 hours after surgery, was not included in this study. 416 patients in observation group, 413 patients in control group. Patient with waking consciousness in observation group was given 50 ml warm water or light salt water 30 rain after surgery, Liquid or semi-liquid diet was given 2 hours after surgery. patients in control was given diet 6 hours after surgery. The symptom of thirst, hunger, throat discomfort, bloating, vomiting and nausea 2 hours after surgery was evaluated, the incidence of bloating, vomiting and nausea 2 hours after diet, and the incidence of aspiration when eating was observed and compared for the two group. Result The incidence of throat discomfort and thirst 2 hours after surgery in control group was higher than that of observation group （P〈0.01） . The extent and number of throat discomfort, thirst and hunger 5 hours after surgery in control group was increased compared with observation group, there was significant difference between the two group. The number of bloating 2 hours after diet in control group was higher than that of observation group（P〈0.01） . No aspiration was found in both group. Conclusion It＇s feasible and safe for early eating for patient with waking consciousness after cervical general anesthesia. It＇s benefit for the recovery of gastrointestinal function and improving the patients＇ postoperative comfortable.