改良式术前肠道准备在妇科腹腔镜子宫切除术患者中的效果分析

目的 分析改良式术前肠道准备在妇科腹腔镜子宫切除术中的效果。 方法 纳入2018年2月—2019年2月期间温州医科大学附属第一医院行腹腔镜子宫切除术患者96例,采用随机数字表法分为观察组、对照组,各48例,分别予以改良式术前肠道准备、常规肠道准备。比较2组患者手术医生满意度、围术期参数、消化道症状、肠道功能恢复情况及术前、术后1 d血清电解质变化。 结果 2组手术医生满意度差异无统计学意义(P>0.05);2组术中不自主排便发生率、术中出血量、手术时间差异无统计学意义(均P>0.05),观察组术后住院时间短于对照组(P<0.05);2组腹胀发生率差异无统计学意义(P>0.05),观察组腹泻、恶心、呕吐发生率分别为0.00%(0/48)、2.08%(1/48)、4.17%(2/48),低于对照组10.42%(5/48)、12.50%(6/48)、16.67%(8/48),χ2=5.275、3.852、4.019,均P<0.05];2组均未出现肠梗阻,观察组术后首次肠蠕动、排便、肛门排气时间分别为(15.16±1.79)h、(41.71±5.83)h、(18.26±2.78)h,短于对照组的(17.35±1.58)h、(49.09±6.31)h、(21.12±2.97)h,t=6.355、5.952、4.871,均P<0.001;观察组术后1 d血清Na+、K+、Cl-均高于对照组(均P<0.05)。 结论 改良式术前肠道准备应用于妇科腹腔镜子宫切除术可促进肠道功能恢复,利于患者术后康复,安全性高。 

Effects of modified preoperative bowel preparation in patients undergoing laparoscopic hysterectomy in gynecology department

Objective To analyze the effects of modified preoperative bowel preparation in patients undergoing laparoscopic hysterectomy in gynecology department. Methods Ninety-six patients who underwent laparoscopic hysterectomy were enrolled in the study. They were divided into observation group and control group according to the random number table method, with 48 cases in each group. And they were given modified preoperative bowel preparation and routine preoperative bowel preparation respectively. The satisfaction of surgeons, perioperative parameters, occurrence of gastrointestinal symptoms, intestinal function recovery and levels of serum electrolytes before surgery and at 1 d after surgery were compared between the two groups. Results There was no significant difference in the satisfaction of surgeons between the two groups(all P>0.05). There were no significant differences in the incidence rate of involuntary defecation, intraoperative blood loss and operative time between the two groups(P>0.05), and the postoperative hospital stay was shorter than control group(P<0.05). There was no significant difference in the incidence rate of abdominal distension between the two groups(P>0.05), and the incidence rates of diarrhea, nausea and vomiting with 0.00%(0/48), 2.08%(1/48) and 4.17%(2/48) in observation group were lower than those in control group10.42%(5/48), 12.50%(6/48) and 16.67%(8/48), χ2=5.275, 3.852, 4.019, all P<0.05]. There was no intestinal obstruction in the two groups, and the postoperative first intestine peristalsis time, postoperative first defecation time and postoperative first anal exhaust time with(15.16±1.79)h,(41.71±5.83) h and(18.26±2.78) h in observation group were shorter than those in control group with(17.35±1.58) h,(49.09±6.31) h and(21.12±2.97) h(t=6.355, 5.952, 4.871, all P<0.001). There were no significant changes in the levels of serum Na+, K+ and Cl- in observation group at 1 d after surgery compared with those before surgery(all P>0.05). The levels of serum Na+, K+ and Cl- in observation group were higher than in control group(all P<0.05). Conclusion Modified preoperative bowel preparation for gynecological laparoscopic hysterectomy can promote the recovery of intestinal function, and it is beneficial to patients with postoperative recovery, it is safe and feasible.