基于加速康复外科理念手术室护士实施禁食禁饮干预对连台手术患者空腹血糖、空腹胰岛素、胰岛素抵抗指数及不良反应的影响

Effect of fasting and drinking prohibition intervention on fasting blood glucose,fasting insulin,insulin resistance index and adverse reactions of operating room nurses based on the concept of accelerated rehabilitation surgery

目的探讨基于加速康复外科(FTS)理念的手术室禁食禁饮干预对连台手术患者空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)及不良反应的影响。方法选取2018年12月~2019年12月在解放军联勤保障部队第九0八医院收治的100例连台手术患者,采用随机数字表法分为对照组和观察组,每组各50例。对照组术前实施常规禁食禁饮干预,观察组在常规干预的基础上,采取基于FTS理念手术室禁食禁饮干预。比较两组的术前禁食、禁饮时间,术前及术后的FPG、FINS、HOMA-IR变化及不良反应。结果观察组术前的禁食时间、禁饮时间短于对照组(P<0.05);两组术前的FPG、FINS及HOMA-IR比较,差异无统计学意义(P>0.05);术后1 d,两组的FPG、FINS及HOMA-IR显著升高,之后呈进行性下降(P<0.05);观察组术后1、3 d时FPG、FINS及HOMA-IR低于对照组,差异均有统计学意义(P<0.05);观察组的口渴、饥饿发生率低于对照组,差异有统计学意义(P<0.05)。结论基于FTS理念的手术室禁食禁饮干预可缩短连台手术患者术前禁食禁饮时间,改善糖代谢及胰岛素抵抗水平,减少不良反应,临床干预效果满意。

Objective To investigate the effect of fasting and drinking prohibition on fasting blood glucose(FPG),fasting insulin(FINS),insulin resistance index(HOMA-IR)and adverse reactions in patients undergoing accelerated rehabilitation surgery(FTS).Methods A total of 100 consecutive operation patients in 908 Hospital,Joint logistics Support Force of PLA from December 2018 to December 2019 were selected.They were divided into control group and observation group,50 cases in each group.The control group received routine preoperative fasting and drinking intervention,while the observation group received fasting and drinking intervention in the operating room based on the concept of FTS.The fasting and drinking time,changes of FPG,FINS,HOMA-IR and adverse reactions before and after operation were compared between the two groups.Results The preoperative fasting time and abstinence time in the observation group were shorter than those in the control group,the differences were statistically significant(P<0.05).There were no statistically significant difference in FPG,FINS and HOMA-IR between the two groups before operation(P>0.05).Compared with preoperation,1 d after operation,FPG,FINS and HOMA-IR in the two groups were increased,followed by a progressive decrease(P<0.05).FPG,FINS and HOMA-IR in the observation group were all lower than those in the control group at 1 and 3 d after operation,the differences were statistically significant(P<0.05).The incidence rates of thirst and hunger in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion The intervention of fasting and drinking in the operating room based on the concept of FTS can shorten the time of fasting and drinking before surgery,improve glucose metabolism and insulin resistance,reduce adverse reactions,and achieve satisfactory clinical effects.