围术期禁食时间对择期手术婴儿舒适度与安全性的影响  

Effect of perioperative fasting time on comfort and safety of infants with elective surgery

作　　者：管文燕[1] 陈智博[1] 肖夕凤 刘慧[1] 陶烨[1] 戚圆 GUAN Wenyan;CHEN Zhibo;XIAO Xifeng;LIU Hui;TAO Ye;QI Yuan(Yangzhou Maternal and Child Health Care Hospital, Affiliated Hospital of Medical College of Yangzhou University, Yangzhou, Jiangsu, 22500)

机构地区：[1]江苏省扬州市妇幼保健院扬州大学医学院附属医院,江苏扬州225002

出　　处：《实用临床医药杂志》2018年第18期115-117,121,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨围术期禁食时间长短对择期手术婴儿舒适度与安全性的影响。方法选择在本院小儿骨科和小儿普通外科住院行择期手术并符合相关要求的母乳喂养婴儿98例作为研究对象,按实际术前禁食时间分为A组(180~240 min)、B组(>240~300 min)、C组(>300 min),比较各组间舒适度评分和安全性差异。手术结束2 h按围术期总计禁食时间将患儿分为a组(330~390 min)、b组(>390~480 min)、c组(>480 min),再次统计各组间舒适度评分差异。采用新生儿疼痛与不适量表评估婴儿舒适度,并采用术中误吸例数评估手术安全性。结果 A组与B组间舒适度评分差异无统计学意义(P>0.05),A组与C组间以及B组与C组间舒适度评分差异有统计学意义(P<0.05);各组均未发生术中误吸。a组与c组间舒适度评分差异有统计学意义(P<0.05),其他组间差异均无统计学意义(P>0.05)。结论缩短1周岁以内婴儿术前禁食母乳时间至4 h左右是舒适而安全的,术后尽早进食母乳也可缓解婴儿不适感,在缩短术前禁食时间和术后早期进食的基础上控制围术期总计禁食时间在6 h以内是较佳的。Objective To explore the effect of perioperative fasting on comfort and safety of infants undergoing elective surgery. Methods A total of 98 breast-feeding infants were selected in departments of orthopedics and pediatric general surgery in our hospital were selected,and were divided into group A（ 180 - 240 min）,group B（ 〉 240 - 300 min） and group C（ 〉 300 min） according to actual preoperation fasting time. The difference of comfort score and safety among groups were analyzed. Those patients were divided into group a（ 330 - 390 min）,group b（ 〉 390 - 480 min）,and group c（ 〉 480 min） according to duration of fasting after 2 h of operation,and the difference of comfort scores among the groups were counted again. The comfort of infants was assessed using Neonatal Pain and Discomfort Scale and the safety of surgery was assessed by the number of intraoperative aspiration cases. Results The comfort scores between A and B group showed significant difference（ P 〉 0. 05）. The comfort score between group C and group A,and between group C and group B showed significant difference（ P 〈 0. 05）. No intraoperative mistaken aspiration occurred in all groups. There was a significant difference in comfort scores between group a and group c（ P 〈0. 05）,but no significant difference was found between the other groups. Conclusion It is comfort and safe to shorten the time of breast-feeding to 4 h for 1 year old infants,and it can also relieve the infantile discomfort after operation. It is better to control the total perioperative fasting time within 6 hours on the basis of shortening preoperative fasting time and early postoperative feeding time.

关 键 词：禁食时间 择期手术 婴儿 舒适度 母乳喂养 新生儿疼痛与不适量表 

分 类 号：R473.72[医药卫生—护理学]