三种口服碳水化合物在胃十二指肠穿孔急诊手术患者加速康复外科中的应用  

The application of three oral carbohydrates on enhanced recovery after surgery for patients with gastroduodenal perforation undergoing emergency surgery

作　　者：黄升 梁善强 梁其海 陆炎 顾梅丽 HUANG Sheng;LIANG Shan-qiang;LIANGQi-hai(Department of Hepatobiliary Gastrointestinal Surgery,Beiliu People’s Hospital,Yulin 537400,China)

机构地区：[1]广西北流市人民医院肝胆胃肠外科

出　　处：《中国实用医药》2019年第32期13-15,共3页China Practical Medicine

基　　金：玉林市科学研究与技术开发计划(项目编号:玉市科20180114)

摘　　要：目的比较三种常见口服碳水化合物应用于胃十二指肠穿孔急诊手术患者术后加速康复外科(ERAS)中的效果。方法60例胃十二指肠穿孔急诊手术患者,根据术后早期给予的口服碳水化合物不同分为葡萄糖组(21例)、术能组(21例)及素乾组(18例)。三组患者术后均接受ERAS管理,葡萄糖组患者给予10%葡萄糖,术能组患者给予术能多维饮料,素乾组给予麦芽糊精果糖饮料(商品名:素乾)。比较三组患者首次进食时间、拔除胃管时间及首次肛门排气时间、出入院体重变化幅度及术后C反应蛋白(CRP)、住院时间、住院费用及并发症发生情况。结果葡萄糖组首次进食中位时间32 h、拔除胃管中位时间55 h,术能组分别为48、93 h,素乾组分别为84、96 h。葡萄糖组及术能组首次进食时间明显短于素乾组,葡萄糖组拔除胃管时间明显短于术能组、素乾组,差异具有统计学意义(P<0.05)。葡萄糖组首次肛门排气时间短于术能组、素乾组,差异具有统计学意义(P<0.05)。葡萄糖组住院时间短于术能组、住院费用低于术能组,差异具有统计学意义(P<0.05)。三组患者的出入院体重变化幅度及术后1、2、3 dCRP水平两两比较差异均无统计学意义(P>0.05)。三组患者术后并发症发生率比较差异无统计学意义(P>0.05)。结论胃十二指肠穿孔急诊手术患者在术后ERAS管理中早期口服10%葡萄糖及素乾的疗效可能优于术能多维饮料。Objective To compare the effect of several oral carbohydrates on enhanced recovery after surgery(ERAS)for emergency surgery patients with gastroduodenal perforation.Methods A total of 60 gastroduodenal perforation patients undergoing emergency surgery were divided into glucose group(21 cases),Shuneng group(21 cases)and Suqian group(18 cases)according to the different oral carbohydrates given early after operation.Three groups all received ERAS management.Glucose group received 10%glucose,Shuneng group received Shuneng multidimensional beverage,and Suqian group received maltodextrin fructose beverage(trade name:Suqian).Comparison was made on time of first feeding,time of gastric tube removal and time of first anal exhaust,change of body weight at admission and discharge,post-operative C-reactive protein(CRP),hospitalization time,hospitalization expenses and occurrence of complications in three groups.Results The median time of first feeding and gastric tube removal were 32 and 55 h in glucose group,which were 48 and 93 h in Shuneng group,and 84 and 96 h in Suqian group.The time of first feeding in glucose group and Shuneng group was obviously shorter than that in Suqian group,and time of gastric tube removal was in glucose group was obviously shorter than that in Shuneng group and Suqian group.Their difference was statistically significant(P<0.05).The time of first anal exhaust in glucose group was obviously shorter than that in Shuneng group and Suqian group,and the difference was statistically significant(P<0.05).The hospitalization time of glucose group was shorter than that of Shuneng group,and hospitalization expenses was lower than that of Shuneng group.Their difference was statistically significant(P<0.05).There was no statistically significant difference in changes of body weight at admission and discharge and C-reactive protein(CRP)levels at 1,2 and 3 d after operation in pairwise comparison(P>0.05).There was no statistically significant difference in incidence of complications after operation in three gr

关 键 词：口服碳水化合物 胃十二指肠穿孔 加速康复外科 

分 类 号：R47[医药卫生—护理学]