不同营养液对麻醉诱导前禁食时间的影响  

Effect of different types of nutrient solution on preoperative fasting time

作　　者：邱维吉[1] 李士通[4] 花天放[5] 白刚[1] 罗禹[2] 高洁婷[3] 孔宁[4] 

机构地区：[1]上海市第一人民医院分院麻醉科,200081 [2]上海市第一人民医院分院放射科,200081 [3]上海市第一人民医院分院营养科,200081 [4]上海市第一人民医院麻醉科,200080 [5]上海市第一人民医院普外科,200080

出　　处：《中华临床营养杂志》2015年第2期73-76,共4页Chinese Journal of Clinical Nutrition

基　　金：上海市青年医师培养资助计划（沪卫人事[2012]114号）;上海市虹口区卫生局医学科研课题立项建设项目（虹卫1203-05）

摘　　要：目的通过测定健康志愿者口服碳水化合物和蛋白质营养液后的胃排空过程，探讨手术前有条件开放饮食的可行性。方法于2013年8月至2014年5月选取20名健康志愿者，研究日晨8点采用磁共振测量基础胃内液体容量，然后于5min内饮完12．5％碳水化合物营养液400ml（含40g麦芽糊精和10g蔗糖）或12．5％的乳清蛋白营养液400ml（含50g乳清蛋白），每隔25min采用磁共振测量胃内液体残留量。间隔1周后口服另一种营养液。计算两种营养液的排空时间并绘制排空曲线。结果志愿者的基础胃内液体容量为（14．90±9．39）ml。口服碳水化合物营养液的完全排空时间为（104．90±27．98）min（95％CI98．64～111．16min）；口服乳清蛋白营养液的完全排空时间为（199．6±34．17）min（95％CI184．47～214．73min），显著长于碳水化合物营养液的排空时间（P〈0．0001）。结论口服碳水化合物溶液2h后可进行麻醉诱导，而口服乳清蛋白溶液后至少需要4h才能进行麻醉诱导。Objective To discuss the feasibility of preoperative diet by measuring gastric emptying time of carbohydrate and protein nutrient solutions in healthy volunteers. Methods A total of 20 healthy volunteers were collected from August 2013 to May 2014. On the morning of the trial, baseline gastric residu- al volume of each volunteer was measured with magnetic resonance imaging at 8 a. m. , then each of the 20 healthy volunteers took 12.5% carbohydrate solution 400 ml （ containing 40 g of maltodextrin and 10 g of su- crose） or 12.5% whey protein solution （ containing 50 g whey protein） in 5 minutes. Magnetic resonance im- aging was conducted to measure the gastric residual volume every 25 minutes. The volunteers were shifted to the other nutrient solution after a 1 -week interval. The gastric emptying time of both nutrient solutions was cal- culated to generate the curves illustrating the process of gastric emptying. Results The baseline gastric re- sidual volume of the volunteers was （ 14.90 ± 9.39 ） ml. The total gastric emptying time of carbohydrate so- lution was （ 104.90 ± 27.98） min （95% CI 98.64 - 111.16 rain）, while that of whey protein solution was （199. 6 ±34. 17） min （95% CI 184.47 -214.73 min）. There was a significant difference between these two types of nutrient solution in terms of gastric emptying time （P 〈 0. 000 1 ）. Conclusions The induction of anesthesia could be performed 2 hours after carbohydrate administration, and at least 4 hours after whey protein administration.

关 键 词：碳水化合物溶液 乳清蛋白溶液 术前禁食 胃排空 磁共振 

分 类 号：R614[医药卫生—麻醉学] R459.3[医药卫生—外科学]