腹腔镜胆囊切除术前不同禁食禁饮时间的临床观察

Clinical observation on influence of different fasting and water restriction time on patients undergoing laparoscopic cholecystectomy

目的探讨术前不同禁食禁饮时间对腹腔镜胆囊切除术患者的影响。方法 180例择期全麻的腹腔镜胆囊切除术患者随机分为A、B、C组,每组60例,其中A组术前禁食12 h,禁饮4 h;B组术前禁食8 h,禁饮2 h;C组术前禁食6 h,禁饮2 h。对比分析3组患者术前低血糖的发生率及患者口渴、寒冷、焦虑程度、饥饿感程度,术中呕吐及误吸的发生率,术后呕吐的发生率。结果 3组患者口渴、饥饿、寒冷、焦虑程度评分的比较,差异有统计学意义(P<0.05),C组口渴、饥饿、寒冷、焦虑程度评分低于A组和B组(P<0.05)。A组术中误吸2例,B组、C组均为0例;3组患者术前低血糖、术后呕吐发生率比较差异有统计学意义(P<0.05),C组术前低血糖、术后呕吐发生率低于A和B组(P<0.05)。结论术前禁食6 h、禁饮2 h方案能提高腹腔镜胆囊切除术患者术前舒适度及围手术期安全。

Objective To investigate the influence of different fasting and water restrictiontime on patients undergoing laparoscopic cholecystectomy. Methods Totally 180 patients under-going lapaoscopic cholecystectomy were randomly divided into group A,group B and group C,with 60 cases in each group. Patients in the group A were treated witti 12 h of fasting anwater restriction before operation. Patients in group Bwere treated with 8 h of fasting and 2 h of water restriction,and those in the group C were treated witli 6 h of fasting and 2 h of water restric-tion. The incidence of preoperative hypoglycemia and the degree of thirst,cold,anxiety,hunger, vomiting and aspiation,and the incidence of postoperative vomiting were compared and analyzed between three groups. Results Patients in the group C had a lower degree of thirst,hunger,cold and anxiety compared with those in the group Aand group B（! 〈0.05） . Only 2 case s of as- piation were observed in the group Aduring operation. The incidence of postoperative vomitingand preoperative hypoglycemia in the group Cthan those in the group Aand group B （P 〈 0. 05） . Conclusion Application of 6 h of fasting and 2 h of water restriction preoperatively may improvethe comfort and safety of patients undergoing laparoscopic cholecystectomy.KEYWORDS： laparoscopy; cholecystectomy; fasting; water restriction; complication; nursing int rv ntion