含化巧克力替代腹腔镜胆囊手术术前输液的效果评价  

Effectiveness Evaluation on Replacing Preoperative Transfusion by Sublingual Chocolate in Laparoscopic Cholecystectomy

作　　者：王晓琼[1] 章伏生[1] 陈红艳[1] 章文龙[1] 缪滔[1] 

机构地区：[1]浙江省台州医院

出　　处：《医院管理论坛》2014年第4期27-29,共3页Hospital Management Forum

基　　金：浙江省医学卫生科技计划项目(2009A220)

摘　　要：目的探讨择期腹腔镜胆囊切除术(LC)患者术前含化巧克力替代术前输液的可行性及安全性。方法将160例LC的患者随机分为两组,即治疗组80例,对照组80例。对照组术前补液;治疗组于麻醉诱导前2-6小时含化35克德芙纯黑巧克力,并测量血糖浓度、胃管引流量,SAS评分。结果对照组与治疗组的血糖浓度,差异无统计学意义(P>0.05);治疗组的胃液量比较差异无统计学意义。两组患者无一例出现吸入性肺炎的麻醉相关并发症。SAS两组比较t值为10.53,P<0.001。治疗组围手术期未补液,对照组的围手术期补液,t值136.06,P值<0.001,有统计学差异;治疗组人均增加工作时间(1.3±0.68)与对照组的人均增加工作时间(8.8±2.66),t值127.75,P值<0.001,有统计学差异。两组术前不同处理措施的成本效益之比为2.23≧1,具有卫生经济效益。结论择期LC的患者术前含化巧克力替代术前输液安全可行,可降低患者的饥饿、虚弱、焦虑等不适感,提供以人为本的护理理念,提高患者满意度,降低住院费用。Objective Discuss the feasibility and safety of replacing preoperative transfusion by sublingual chocolate on patients for laparoscopic cholecystectomy （LC）. Methods Randomly divide 160 LC patients into two groups with 80 cases in each group. The control group took preoperative transfusion while the treatment group took 35g suhlingual Dove black chocolate 2-6 hours before anesthesia induction. Take their blood glucose concentration, gastric tube drainage volume and SAS grade. Results The difference of b]ood glucose concentration and gastric tube drainage volume between control group and treatment group has no statistical significance （P〉0.05）. No patients occurred anesthesia related complication of aspiration pneumonia for both groups. T value of SAS grade comparison is 10.53 and P〈0.001. T value for perioperative transfusion on control group is 136.06 and P 〈0.001 with statistical significance. The increase of working hours per capita for treatment group is （1.3 ± 0.68） while （8.8± 2.66） for control group, with T value of 127.75 and P〈0.00）. The cost-effectiveness ratio of different intervention measures for both groups is of health economic effectiveness （2.23 ≥ 1）. Conclusion Replacing preoperative transfusion by sublingual chocolate on patients for LC is safe and feasible with lower inpatient expense, which could improve patients＂ hunger, weakness and anxiousness and improve patient satisfaction.

关 键 词：胆囊 腹腔镜 手术前 输液 效果 

分 类 号：R657.4[医药卫生—外科学]