妇科手术前不同肠道准备方法的效果比较

目的 比较妇科手术前3种不同肠道准备方法对患者肠道清洁度、不良反应状况、术后排气时间及血钾和血糖情况,以寻找出一种最佳的妇科肠道准备方法.方法 选择2010年10月-2012年9月在复旦大学附属肿瘤医院行妇科手术患者600例,随机分成3组,A组术前给予口服20％甘露醇500 mL＋复方聚乙二醇电解质散剂（舒泰清）1盒；B组给予口服舒泰清1盒＋11omL甘油灌肠剂灌肠2次；C组给予口服舒泰清3盒.观察3种不同肠道准备方法对患者肠道清洁度、不良反应状况及术后肠功能恢复情况.结果 3组患者术中肠道清洁度比较,差异无统计学意义（P＞0.05）；3组患者中,A组发生恶心呕吐为最高,B组发生腹痛为最高,C组发生疲劳乏力为最高；3组患者术后排气时间比较差异无统计学意义（P＞0.05）；3组患者肠道准备前后血钾和血糖变化比较差异无统计学意义（P＞0.05）.结论 妇科手术前单纯服用舒泰清作为肠道准备方法,能起到清洁肠道的作用,且患者不良反应少,易于接受.

Comparison of three methods of bowel preparation before gynecological operation

Objective To compare the adverse reactions,cleanliness of intestinal tract and recovery of intestinal function of three methods of bowel preparation before gynecological operation,and to find out the best method.Methods A total of 600 patients in Fudan University Shanghai Cancer Center who received gynecological operation during October 2010 to September 2011 were randomized into three groups.The patients in group A took 500 mL mannite and a box of polyethylene glycol electrolyte orally,the patients in group B took a box of polyethylene glycol electrolyte orally and 110 mL glycerine enema twice,and the patients in group C took three boxes of polyethylene glycol electrolyte orally.The adverse reactions,cleanliness of intestinal tract and recovery of intestinal function in three groups were analyzed.Results There was no significant difference in the cleanliness of intestinal tract in three methods （P ＞ 0.05）.Nausea,vomiting,bellyache and fatigue occurred in all three groups after taking laxatives.The rates of nausea,vomiting,bellyache and fatigue were 55.21％,21.88％,4.17％ and 5.73％ in group A.In group B,the rates were 5.21％,2.08％,16.15％ and 0.52％,respectively.And in group C,the rates were 15.03％,2.59％,2.59％ and 6.22％,respectively.Group A had the highest rates of nausea and vomiting.Group B had the highest rate of bellyache.And group C had the highest rate of fatigue.There were no significant differences in exhaust time and changes in potassium and blood sugar levels among three methods （P ＞ 0.05）.Conclusion Taking polyethylene glycol electrolyte orally as bowel preparation before a gynecological operation can reduce pain.It is safe,effective and easier to be accepted.It can be performed easily and reduce the nursing workload.