术前禁食禁饮再造流程在肿瘤外科择期手术患者中的应用

Application of reconstructed preoperative fasting and forbidding drink process in elective surgery patients of surgical oncology

目的 探讨如何在临床实践中缩短术前禁食禁饮的时间及再造流程的临床应用.方法 采用便利抽样法选择2015年11月1—20日及2015年12月10—30日在温州医科大学附属第一医院肿瘤外科行择期手术患者226例为研究对象,以2015年11月1—20日纳入的患者为对照组,以2015年12月10—30日纳入的患者为试验组;对照组采用传统术前禁食禁饮方案,试验组采用再造流程实施术前禁食禁饮新方案;比较两组患者术前禁食禁饮时间及术前相关不良反应的发生情况.结果 试验组患者术前实际禁食时间为（7.60±0.98）h,短于对照组的（14.48±5.08）h,差异有统计学意义（t=13.849,P＜0.01）;试验组患者术前实际禁饮时间为（3.39±0.97）h,短于对照组的（11.47±4.99）h,差异有统计学意义（t=19.545,P＜0.01）;试验组术前口渴、饥饿等不适反应的总发生率为14.7%（16/109）,低于对照组的35.9%（42/117）,差异有统计学意义（χ2=13.317,P＜0.01）;两组患者均未发生术中误吸.结论 规范实施术前禁食禁饮新流程,能有效缩短术前禁食禁饮时间,改善择期手术患者术前的不适体验.

Objective To study how to shorten the time of preoperative fasting and forbidding drink in clinical practice and the clinical application of its reconstructed process.Methods A total of 226 elective surgery patients,from the Department of Surgical Oncology of the First Affiliated Hospital of Wenzhou Medical University from November 1st,2015 to November 20th,2015 and from December 10th,2015 to December 30th, 2015,were selected by convenient sampling method as the research object. They were divided into the control group （n=117） and the experimental group （n=109） by using the before-and-after study method. In the control group,traditional preoperative fasting and forbidding drink process was adopted. In the experimental group,the new reconstructed preoperative fasting and forbidding drink process was adopted. The actual time of preoperative fasting and forbidding drink and the incidence of preoperative related adverse events were compared between two groups.Results The actual time of preoperative fasting was （7.60±0.98） h in the experimental group,which was significantly shorter than that in the control group （14.48±5.08）h（t=13.849,P〈0.01）. The actual time of preoperative forbidding drink was （3.39±0.97） h in the experimental group,which was significantly shorter than that in the control group （11.47±4.99）h（t=19.545,P〈0.01）. In the experimental group,the total incidence of adverse responses such as thirst and hunger before operation was 14.7%（16/109）,which was significantly lower compared to the control group 35.9%（42/117）（χ2=13.317,P〈0.01）. There was no intraoperative aspiration in both groups.Conclusions The standard implementation of the new preoperative fasting and forbidding drink process can effectively shorten the preoperative fasting and forbidding drink time and improve the preoperative discomfort of elective surgery patients.