外科手术病人术前禁食禁饮最佳证据的遴选与应用  

Selection and application of the best evidence for preoperative fasting in surgical patients

作　　者：郭晶 陈彩虹 姚芳 吴晓芳 鲁亮 邬维娜 GUO Jing;CHEN Caihong;YAO Fang;WU Xiaofang;LU Liang;WU Weina(School of Nursing,Hangzhou Medical College,Zhejiang 310053 China)

机构地区：[1]杭州医学院护理学院,浙江310053 [2]杭州市临平区中医院

出　　处：《循证护理》2022年第16期2169-2173,共5页Chinese Evidence-Based Nursing

基　　金：浙江省教育厅一般科研项目,编号:Y201942614;浙江省医药卫生科技计划项目,编号:2013KYB075。

摘　　要：目的:将术前禁食禁饮最佳证据应用于外科临床实践,以改善病人的舒适度。方法:以ACE Star循证实践模式为指导,遴选出5条最佳证据,构建禁食禁饮实践方案,并应用于外科病房手术病人。将符合纳入排除标准的90例病人随机分为对照组、干预1组和干预2组,分别实施不同禁食禁饮时间和干预,最后以麻醉诱导前病人禁食禁饮时间、主观感受评分(VAS)、生理指标评价证据应用后的效果。结果:干预1组和干预2组术前禁食禁饮时间明显短于对照组(P<0.05),且病人术前口渴、饥饿、头晕、头痛、心慌、出汗、乏力、紧张、焦虑的主观感受评分低于对照组,差异有统计学意义(P<0.05),病人血糖及胰岛素水平均明显高于对照组(P<0.05)。结论:基于循证的禁食禁饮方案可提升病人的舒适度,使临床变革更科学、有效。Objective:The best evidence of preoperative fasting was applied to surgical clinical practice to improve the comfort of patients.Methods:Under the guidance of ACE Star evidence-based practice model,five best evidences were selected,and the fasting practice scheme was constructed and applied to the surgical ward.90 patients who met the inclusion and exclusion criteria were randomly divided into control group,intervention group 1 and intervention group 2.Different fasting time and intervention were implemented respectively.Finally,the effect of evidence application was evaluated by fasting time before anesthesia induction,Visual Analogue Scale(VAS)and physiological indicators.Results:The preoperative fasting time of the two intervention groups was significantly lower than that of the control group(P<0.05);The subjective feeling scores of thirst,hunger,dizziness,headache,palpitation,sweating,fatigue,tension and anxiety in the two intervention groups were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of blood glucose and insulin in the two intervention groups were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion:The evidence-based fasting scheme can improve the comfort of patients and make the clinical reform more scientific and effective.

关 键 词：禁食禁饮 外科 手术病人 术前 最佳证据 循证实践 

分 类 号：R473.6[医药卫生—护理学]