两种术前肠道准备方法在腹腔镜全子宫切除术中的应用效果比较  

Comparison of application effect of the two preoperative bowel preparation methods in laparoscopic total hysterectomy

作　　者：韩阁阁 谢艳艳 李岑 何素丽 孙玉洁 HAN Gege;XIE Yanyan;LI Cen;HE Suli;SUN Yujie(Department of Gynecology,Affiliated Hospital of Yangzhou University,Jiangsu Province,Yangzhou 225000,China)

机构地区：[1]扬州大学附属医院妇科,江苏扬州225000

出　　处：《妇儿健康导刊》2023年第3期34-36,共3页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

摘　　要：目的探讨不同术前肠道准备在妇科良性疾病行腹腔镜全子宫切除术中的应用效果。方法选取2022年2月至8月在扬州大学附属医院妇科行腹腔镜全子宫切除术的120例患者,按随机数字法分为凌晨禁食组、乳果糖组,每组各60例。比较两组的术前不适症状、术中出血量、手术时间、术后肛门排气时间、术后电解质紊乱发生率、术后补液时间等。结果乳果糖组的术前恶心呕吐、夜间饥饿痛发生率高于凌晨禁食组(P<0.05)。乳果糖组的术中出血量[(41.83±18.64)ml]多于凌晨禁食组[(33.42±19.08)ml],差异有统计学意义(P<0.05)。乳果糖组的低钾血症、低氯血症发生率(28.3%、16.7%)高于凌晨禁食组(6.7%、5.0%),差异有统计学意义(P<0.05)。结论对妇科良性疾病行腹腔镜全子宫切除术的患者进行术前肠道准备,会明显增加术后电解质紊乱发生率、术中出血量等,而是否在术前行肠道准备不影响术后恢复情况。无盆腔重度粘连患者可不进行术前机械性肠道准备。Objective To explore the application effect of different preoperative bowel preparation in laparoscopic total hysterectomy for benign gynecological diseases.Methods A total of 120 patients who underwent laparoscopic total hysterectomy in Department of Gynecology,Affiliated Hospital of Yangzhou University from February to August 2022 were selected and divided into early morning fasting group and lactulose group according to the random number method,with 60 cases in each group.The preoperative discomfort symptoms,intraoperative blood loss,operation time,postoperative anal exhaust time,incidence of postoperative electrolyte disturbance,and postoperative fluid infusion time were compared between the two groups.Results The incidence of preoperative nausea and vomiting and nocturnal hunger pain in the lactulose group was higher than that in the early morning fasting group(P<0.05).The intraoperative blood loss in the lactulose group([41.83±18.64]ml)was more than that in the early morning fasting group([33.42±19.08]ml),and the difference was statistically significant(P<0.05).The incidence rates of hypokalemia and hypochloraemia in the lactulose group(28.3%,16.7%)were higher than those in the early morning fasting group(6.7%,5.0%),and the differences were statistically significant(P<0.05).Conclusion Preoperative bowel preparation for patients with benign gynecological disease undergoing laparoscopic total hysterectomy will significantly increase the incidence of postoperative electrolyte disturbance and intraoperative blood loss,while preoperative bowel preparation does not affect postoperative recovery.Preoperative mechanical bowel preparation is not required for patients without severe pelvic adhesions.

关 键 词：腹腔镜 妇科良性疾病 机械性肠道准备 

分 类 号：R713[医药卫生—妇产科学]