缩短肝胆疾病患者胃镜检查后禁食时间的安全性研究

Safety of shorterning fasting time after gastroscopy in patients with hepato-biliary diseases

目的探讨肝胆疾病患者胃镜检查后提前进餐的安全性和可行性。方法以2014年1月至2014年4月因肝胆疾病住院需行胃镜检查的患者为研究对象，依据胃镜检查结果分别收集食管胃底静脉曲张患者、活检患者及未行活检的非食管胃底静脉曲张患者各100例，采用区组随机数字表法均分入试验组和对照组，每组食管静脉曲张患者、活检患者及未行活检的非食管胃底静脉曲张各50例。对照组和试验组分别于胃镜检查后2h和30min恢复进食水，对比观察2组口渴、饥饿、低血糖及进食后呛咳、误吸、恶心呕吐、呕血黑便等不良反应的发生情况。结果在恢复进食时，2组在口渴、饥饿的发生率上差异均无统计学意义（P〉0．05），但试验组低血糖发生率（2．0％，3／150）明显低于对照组（9．3％，14／150）（P=0．006）；在胃镜检查后5～8h，2组在进食时呛咳、误吸、恶心呕吐的发生率上差异均无统计学意义（P〉0．05）；在胃镜检查结束后24h，2组均无呕血黑便等上消化道出血情况发生。结论缩短肝胆疾病患者胃镜检查后禁食时间是安全可行的。

Objective To evaluate the safety and feasibility of shorterning fasting time after gastroscopy in patients with hepato-biliary disease. Methods A total of 300 inpatient cases of hepato-biliary disea- ses who underwent gastroscopy were divided into the treatment group （n = 150） and the control group （n = 150） using randomized block design. Both groups included three blocks： patients with esophageal and/or gastric varices （n = 50 ） , patients undergoing biopsy （n = 50 ） and non-esophageal gastric varices patients without biopsy （n = 50） according to the results of gastroscopy. Patients of both groups were asked to eat 2 hours later and drink 30 minutes later after gastroscopy respectively. The symptoms of thirst, hunger, hypoglycemia, choking cough after eating, aspiration, nausea and vomiting, hematemesis and melena were recorded and compared between the two groups. Results There were no significant differences in the incidences between the two groups in thirst and hunger. However the incidence of hypoglycemia was significantly lower in the treatment group than in the control group [ （2. 0% （3/150） VS 9. 3% （14/150） ,P =0. 006]. And there were also no significant differences in the incidences of choking cough, aspiration, nausea and vomiting 5-8 hours after the procedure. Neither hematemesis nor melena was found in either groups 24 hours after the procedure. Conclusion Shortening the fasting time after gastroscopy in patients with hepato-biliary diseases is safe and feasible.