两种术前禁食禁饮方案对择期剖宫初产妇围术期的影响

目的 探讨两种术前禁食禁饮方案对择期剖宫初产妇围术期的影响.方法 选取2015年11月~2016年11月在该院住院择期行剖宫产的300例初产妇为研究对象,随机分为实验组和对照组各150例.实验组(快速康复)采用术前禁食6h、禁饮2h方案,对照组(常规禁食禁饮)采用传统常规的术前禁食12 h、禁饮4 h标准.观察并记录两组初产妇围术期低血糖反应、术前和术中残余胃液量、术前舒适度、术中呕吐和麻醉误吸、术后情况(术后恶心、呕吐、口渴、饥饿和肺炎)及术后肛门恢复排气排便时间,并对收集数据进行统计学处理.结果 实验组低血糖反应发生率、术前残余胃液量和术前口渴、饥饿、心慌疲乏无力、焦虑及术后肛门恢复排气排便时间显著低于对照组,差异均有统计学意义(均P<0.05);两组均无1例初产妇发生术中呕吐、麻醉误吸;两组术中残余胃液量及术后恶心、呕吐、口渴、饥饿和肺炎比较,差异均无统计学意义(均P>0.05).结论 适当缩短术前禁食禁饮时限是安全可行的,不仅降低了围术期的低血糖反应发生率,提高了术前舒适度,并未增加术中、术后风险和并发症,还利于剖宫初产妇术后胃肠功能的提早、快速康复,值得临床推广应用.

The influence of perioperative period of two preoperative fasting and water-depriva-tion schemes on elective cesarean section primipara

Objective To investigate the influence of perioperative period of two preoperative fasting and wa-ter-deprivation schemes on elective cesarean section primipara. Methods A total of 300 primiparas received to have e-lective cesarean section in this hospital from November 2015 to November 2016 were selected as the research objects. They were divided into experimental group and control group, 150 cases of each group. 6 hours preoperative fasting and 2 hours water deprivation scheme were applied in experimental group ( fast rehabilitation group ) . Traditional conven-tional 12 hours preoperative fasting and 4 hours water deprivation standards were applied in control group ( conventional fasting and water deprivation group) . The hypoglycemia reaction, preoperative and intraoperative residual gastric fluid volume, preoperative degree of comfort, intraoperative vomiting and anesthesia aspiration, postoperative situation ( postoperative nausea, vomiting, thirst, hunger and pneumonia) and postoperative anus recovery exhaust and defeca-tion time of primiparas in both groups during perioperative period were observed and recorded. In addition, statistical processing was conducted to the data collection (P>0. 05). Results Hypoglycemia reaction occurrence, preoperative residual gastric fluid volume, preoperative thirst, preoperative hunger, preoperative fatigue and inertia, preoperative anxiety, postoperative anus recovery exhaust and defecation time of the experimental group was significantly lower than control group, and the differences were statistically significant (P<0. 05). There was no primipara that had intraopera-tive vomiting and anesthesia aspiration in experimental group and control group. With regard to the comparison of intrao-perative residual gastric fluid volume, postoperative nausea, postoperative vomiting, postoperative thirst, hunger and postoperative pneumonia in the experimental group and control group, the differences had no statistical significance. Conclusions It's feasible to properly shorten the time limit of preoperative fasting and water deprivation. It can not on-ly reduce the hypoglycemia reaction occurrence in perioperative period, improve preoperative degree of comfort, not in-crease intraoperative and postoperative risk and complication, but also be beneficial to recover postoperative gastrointes-tinal function of cesarean section primiparas early and fast, which is worth having clinical promotion and application.