术前不同禁饮时间对胃液量及其pH值的影响  

Effects of Different Duration of Water Fasting on Gastric Fluid Volume and pH in Patients Undergoing Gynecologic Laparoscopic Surgery

作　　者：王婷婷[1] 黄绍强[1] 葛圣金[2] 耿桂启[1] 刘海恋[1] 

机构地区：[1]复旦大学附属妇产科医院麻醉科,上海200011 [2]复旦大学附属中山医院麻醉科,上海200032

出　　处：《中国临床医学》2012年第2期169-171,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:比较术前不同禁饮时间对手术开始前残留胃液量、胃液pH值的影响。方法:选择66例择期在全身麻醉下接受妇科腹腔镜手术的患者。根据患者术前禁饮时间分为3组:2～4h组、4～8h组和>8h组。所有患者入手术室前填写Zung焦虑自评量表(SAS),并采用视觉模拟评分法(VAS)对口渴、饥饿的不适程度进行评分;常规全麻诱导并气管插管后置入多孔鼻胃管抽吸胃液,测定胃液量及pH值。结果:禁饮时间2～4h组和>8h组各有1例患者焦虑评分分别为51分和57分,将其剔除出研究组,故3组分别有21、22、21例患者纳入本研究。3组在年龄、体质量、身高、体质量指数(BMI)、焦虑评分方面的差异无统计学意义。3组残留胃液量分别为(20.0±4.5)mL、(19.8±2.4)mL和(24.3±2.6)mL;胃液pH值分别为(1.7±0.1)、(2.1±0.3)和(1.7±0.1),差异均无统计学意义。3组口渴及饥饿评分分别为(1.7±0.3)分、(1.0±0.3)分,(3.5±0.5)分、(3.5±0.6)分,(4.2±0.6)分、(4.8±0.8)分;2～4h组口渴、饥饿评分较4～8h组及>8h组显著降低。结论:术前禁饮时间2～4h及以上对择期妇科腹腔镜手术患者手术开始前残留胃液量及其pH值无显著影响,禁饮时间短可降低患者口渴和饥饿的不适感。Objective：To determine the effects of duration of water fasting on gastric fluid volume and pH in patients before the elective gynecologic laparoscopic surgery.Methods：A total of 66 adult patients underwent elective gynecologic laparoscopic surgery under general anesthesia were studied.All patients were divided randomly into 3 groups：Group A,Group B and Group C by water fasting for 2-4 h,4-8 h and 〉8 h,respectively.Visual analog scales were used to assess the hungry and thirsty variables and Zung self-rating anxiety scale（SAS） was used to assess anxious degree.After the induction of general anesthesia and tracheal intubation,gastric contents were aspirated through a multiporous nasogastric tube.The volume and pH of gastric fluid were recorded.Results： One patient in Group A and another in Group C were excluded because of anxiety scale of 51 and 57.Gastric fluid volumes in Group A（n=21）,Group B（n=22） and Group C（n=21） were（20.0±4.5） mL,（19.8±2.4） mL and（24.3±2.6） ml,respectively.The pH values were（1.7±0.1）,（2.1±0.3） and（1.7±0.1）,respectively.There was no significant difference among the three groups.The thirsty and hungry scores among the three groups were（1.7±0.3）,（1.0±0.3）;（3.5±0.5）,（3.5±0.6）;and（4.2±0.6）,（4.8±0.8）,respectively.The thirsty and hungry scores in Group A were significantly lower than those in the other two groups（P〈0.05）.Conclusions： Drinking 200 ml clear water at 2-4 h before induction of anesthesia has no significant effect on gastric fluid volume and pH in patients before the elective gynecologic laparoscopic surgery,but it can alleviate thirst and hunger.

关 键 词：术前禁饮 残留胃液量 胃液PH值 焦虑 

分 类 号：R619[医药卫生—外科学]