儿童择期手术前禁食禁饮方案的Meta分析

A Meta-analysis of preoperative fasting and water deprivation in elective surgical children

[目的]系统评价美国麻醉医师协会推荐的患儿择期手术术前禁食禁饮方案的临床效果和安全性,为患儿禁饮食方案的制订提供科学依据。[方法]全面检索数据库,并对文献进行筛选,运用RevMan5.2软件对符合纳入标准的随机对照试验研究进行Meta分析。[结果]共纳入9篇文献,Meta分析结果显示美国麻醉医师协会推荐的禁食禁饮方案能够降低患儿术前口渴[RR=0.24,95%CI(0.18,0.32),P<0.01]、饥饿[RR=0.28,95%CI(0.13,0.58),P<0.01)]、疲乏无力[RR=0.12,95%CI(0.09,0.18),P<0.01]、哭闹[RR=0.24,95%CI(0.18,0.33),P<0.01]的发生率,且没有证据表明实施新方案能够影响患儿术前烦躁的发生率[RR=0.31,95%CI(0.07,1.34),P>0.01]以及术中呕吐、误吸的发生率[RR=0.86,95%CI(0.60,1.23),P>0.01]。[结论]在临床实践中,采用美国麻醉医师协会推荐的禁食禁饮方案是安全的,效果优于传统禁食禁饮方案。

Objective：To assess the clinical effect and safety of preoperative fasting and water deprivation recommended by American Society of Anesthesiologists.Methods：Retrieved through databases and screened documents.RevMan5.2software was used for Meta-analysis on randomized controlled trials those were up to standards.Results：9RCTs involving 1852 children were included.Meta-analysis showed that less preoperative thirst（RR=0.24,95%CI：0.18~0.32,P〈0.01）,hunger（RR=0.28,95%CI：0.13~0.58,P〈0.01）,fatigue（RR=0.12,95%CI：0.09~0.18,P〈0.01）,crying（RR=0.24,95%CI：0.18-0.33,P〈0.01）were reported by those following preoperative fasting and water deprivation recommended by American Society of Anesthesiologists.No evidence showed that the new plan would impact the risk of irritability before surgery（RR=0.31,95%CI：0.07~1.34,P〈0.01）,neither would it affect the risk of vomit and aspiration during the surgery（RR=0.86,95%CI：0.60~1.23,P〈0.01）.Conclusion：The recommended program of preoperative fasting and water deprivation by American Society of Anesthesiologists was safe,and the effect was better than traditional programs.