Effect of shortening preoperative time of fasting and forbidding water on clinical outcome of elderly patients with gastrointestinal cancer
- Author:
- No author available
- Journal Title:
- World Chinese Journal of Digestology
- Issue:
- 2
- DOI:
- 10.11569/wcjd.v28.i2.58
- Key Word:
- 缩短术前禁食饮时间;老年;胃肠道肿瘤;临床效果
Abstract： 背景 术前长时间禁食禁饮易导致患者发生饥饿、口渴、低血糖等不良反应,尤其是老年患者,目前大部分研究观点支持缩短术前禁食禁饮时间,而国内术前禁食禁饮指南的对象是小儿,成人方面还未有权威指南给予指导.目的 观察缩短术前禁食饮时间对老年胃肠道肿瘤患者临床效果的影响.方法 将100例老年胃肠道肿瘤患者分为对照组和试验组,每组各50例.对照组患者术前禁食12 h、禁饮6h,试验组患者术前禁食6h、禁饮2h.观察并记录两组患者术前反应,麻醉效果,苏醒时间,术前及术后5 min血流动力学指数[血压(mean arterial pressure,MAP)、心率(heart rate,HR)]和血氧饱和度(pulse oxygen saturation,SPO2)的变化,并记录术后康复效果.结果 (1)试验组6例(12％)、对照组29例(58％)存在口渴、饥饿、乏力、希望进食等术前反应,两组比较差异有统计学意义(x2=23.253,P＜0.001);(2)与术前相比,试验组与对照组患者在术后5 min MAP、HR及SPO2均明显下降(P＜0.05),在术后5 min,试验组患者HR及SPO2高于对照组,差异均具有统计学意义(P＞0.05),而两组患者MAP比较,差异无统计学意义(P＜0.05);(3)试验组与对照组患者术中麻醉效果比较,差异无统计学意义(P＞0.05),而两组患者苏醒时间比较,差异有统计学意义(t=-3.121,P=0.002);(4)试验组与对照组患者术后胃管拔除时间、肛门排气时间、体温恢复正常时间以及住院天数比较,差异均有统计学意义(P＜0.05);(5)试验组与对照组患者术后恶心、呕吐、口渴、饥饿和肺炎比较,差异均无统计学意义(P＞0.05).结论 合理安排老年胃肠道肿瘤患者术前禁食饮时间,可能降低患者的术前不适反应,有效改善患者治疗的临床效果,对手术的顺利开展及促进患者术后康复有重要意义.
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