缩短术前禁食禁饮时间对腰椎间盘突出症微创手术患者的影响

The effect of shortening the time of preoperative fasting and fluid limitation on lumber disc herniation patients undergoing minimally invasive surgery

目的探讨缩短术前禁食禁饮时间在腰椎间盘突出症微创手术患者中应用的安全性和必要性。方法 2015年4月—9月,将符合纳入标准的141例患者分为对照组70例和干预组71例,对照组实施传统禁食方案,干预组实施新禁食方案,比较两组患者禁食禁饮时间,饥饿、口渴、术中误吸、术后恶心呕吐、术后腹胀等发生率,以及住院体验和住院时间。结果对照组术前禁食平均为(13.09±2.30)h、术前禁饮时间平均为(7.84±2.10)h,干预组术前禁食平均为(6.88±0.96)h、术前禁饮时间平均为(4.68±1.08)h;干预组口渴发生率较对照组明显降低(P<0.05),住院体验明显改善(P<0.05),术后恶心呕吐、腹胀发生率及住院时间比较差异无统计学意义(P>0.05)。结论缩短术前禁食禁饮时间能改善腰椎间盘突出症微创手术患者的住院体验,且不增加并发症的发生,可以在临床上逐步推广应用。

Objective To evaluate the safety and necessity of shortening the time of preoperative fasting and fluid limitation in lumber disc herniation patients undergoing minimally invasive surgery. Methods A total of 141 eligible patients were assigned into the control group （n-70） and the intervention group （n=71） between April and September 2015. The control group received traditional fasting method while the intervention group received new preoperative fasting method. The time of fasting food and fluid limitation, the incidences of hunger, thirsty, aspiration, postoperative nausea and vomiting, postoperative abdominal distension, and length of stay and the subjective feeling in hospital were compared between the two groups. Results The average time of preoperative fasting and fluid limitation were （13.09±2.30） and （7.84±2.10） hours in the control group and （6.88±0.96） and （4.68±1.08） hours in the intervention group. The incidence of thirsty in the intervention group was shorter than that in the control group, and the subjective feeling in hospital of the intervention group was better than that in the control group （P〈0.05）. There were no significant differences in the incidence of postoperative nausea and vomiting, the incidence of postoperative abdominal distension, and length of hospital stay between the two groups （P〉0.05）. Conclusions Shortening the time of preoperative fasting and fluid limitation can improve the subjective feeling in hospital of lumber disc herniation patients undergoing minimally invasive surgery, not increasing the incidences of complications. It can be applied gradually.