术前不同进饮干预在慢性鼻窦炎患者鼻内镜手术围手术期中的应用研究

Application of preoperative drinking intervention in perioperative period of endoscopic sinus surgery for patients with chronic rhinosinusitis

目的探讨术前不同进饮干预在慢性鼻窦炎患者功能性鼻内镜手术围手术期中的应用效果。方法选取2020年9月至2022年8月诊断为慢性鼻窦炎并行功能性鼻内镜手术治疗的207例患者为研究对象,按不同临床类型分为慢性鼻窦炎伴鼻息肉(101例)、慢性鼻窦炎不伴鼻息肉(106例),再随机分为能量合剂组、糖盐组、对照组。通过选择不同术前进饮干预,评估各组术前、术后的饥饿、口渴、焦虑状况,记录术前、术中、术后2 h的血糖及电解质水平变化,观察返流、误吸及恶心呕吐发生情况。结果相同临床类型的相同时点能量合剂组、糖盐组与对照组比较,术中电解质K^(+)、术中血糖、术后2 h血糖水平均升高,差异有统计学意义(P<0.05)。相同临床类型的能量合剂组、糖盐组术前和术后口渴、饥饿及焦虑评分均低于相同时点的对照组,差异有统计学意义(P<0.05)。各组术后恶心呕吐发生率无明显差异(P>0.05),均未发生返流、误吸。结论术前2~3 h进饮碳水化合物能缓解围手术期焦虑、饥饿、口渴等不适感,维持血糖、电解质稳定,且不增加返流、误吸风险,促进术后恢复。

Objective To explore the application effect of preoperative different drinking intervention in the perioperative period of functional endoscopic sinus surgery.Methods A total of 207 patients diagnosed as chronic rhinosinusitis and treated by endoscopic sinus surgery from September 2020 to August 2022 were selected as the study subjects.According to different clinical types,they were divided into the chronic sinusitis complicating nasal polyps(101 cases),chronic sinusitis without complicating nasal polyps(106 cases),and then randomly divided into the energy mixture group,the glucose saline group,and the control group.By selecting different preoperative drinking interventions,the status of hunger,thirst and anxiety before and after surgery was evaluated,the changes of blood glucose and electrolyte levels before operation,during operation and at 2 h after operation were recorded,and the occurrence of reflux,aspiration and postoperative nausea and vomiting were observed.Results Compared with the control group,the levels of intraoperative electrolyte K^(+),intraoperative blood glucose and blood glucose at 2 h after surgery at the same time point in the energy mixture group and the sugar salt group for the same clinical type were increased,and the differences were statistically significant(P<0.05).The preoperative and postoperative thirst,hunger,and anxiety scores in the energy mixture group and the sugar salt group of the same clinical type were lower than those in the control group at the same time point,and the differences were statistically significant(P<0.05).There were no significant differences in the incidence rate of postoperative nausea and vomiting among the three groups(P>0.05),and no reflux aspiration occurred.Conclusion Intake of carbohydrates at 2-3 h before surgery can alleviate perioperative anxiety,hunger,thirst and other discomfort,maintain blood sugar and electrolyte stabilization without increasing the risk of reflux aspiration,and promote postoperative recovery.