优化术前禁食禁饮方案对日间妇科全身麻醉手术患者的影响  

Impact of optimized preoperative fasting scheme for patients with gynecological day surgery under general anesthesia

作　　者：李明轩[1,2] 何静 王晓凤 陈恒禧[2,3] 谭欣 胡娟[2,4] LI Mingxuan;HE Jing;WANG Xiaofeng;CHEN Hengxi;TAN Xin;HU Juan(Department of Day Surgery,West China Second University Hospital,Sichuan University/West China School of Nursing,Sichuan University,Chengdu,Sichuan 610066,P.R.China;Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University),Ministry of Education,Chengdu,Sichuan 610041,P.R.China;Department of Day Surgery,West China Second University Hospital,Sichuan University,Chengdu,Sichuan 610066,P.R.China;Department of Nursing,West China Second University Hospital,Sichuan University/West China School of Nursing,Sichuan University,Chengdu,Sichuan 610041,P.R.China)

机构地区：[1]四川大学华西第二医院日间手术部/四川大学华西护理学院,成都610066 [2]出生缺陷与相关妇儿疾病教育部重点实验室,成都610041 [3]四川大学华西第二医院日间手术部,成都610066 [4]四川大学华西第二医院护理部/四川大学华西护理学院,成都610041

出　　处：《华西医学》2023年第2期206-209,共4页West China Medical Journal

摘　　要：目的 探讨优化术前禁食禁饮方案对日间妇科全身麻醉(全麻)患者的影响。方法 回顾性选取四川大学华西第二医院日间手术部2021年6月-8月日间妇科全麻手术患者639例作为对照组,采用常规术前禁食禁饮方案;2021年11月-2022年2月日间妇科全麻手术患者920例作为观察组,采用优化后的术前禁食禁饮方案;比较两组患者术前禁饮时间,术中、术后误吸发生情况,以及日间妇科腹腔镜全麻术后首次肛门排气时间的差异。结果 对照组与观察组术前禁饮时间分别为(12.49±2.63)、(6.69±2.76)h,差异有统计学意义(P<0.05);两组术中、术后均未发生误吸;腹腔镜全麻术后患者中,对照组(n=103)和观察组(n=146)首次肛门排气时间分别为(11.51±6.58)、(8.19±4.13)h,差异有统计学意义(P<0.05)。结论 采用优化后的术前禁食禁饮方案可有效缩短日间妇科全麻手术前禁饮时间而不增加麻醉风险,同时可加快日间妇科全麻腹腔镜患者术后肠道功能恢复,促进加速康复外科实践落地,提升日间手术开展效率。Objective To investigate the impact of optimized preoperative fasting scheme for gynecological day surgery with general anesthesia. Methods We retrospectively selected 639 patients undergoing gynecological day surgery with general anesthesia between June 2021 and August 2021 in the day surgery department of West China Second University Hospital of Sichuan University as the control group, and 920 patients undergoing gynecological day surgery with general anesthesia in the same hospital between November 2021 and February 2022 as the observational group. The patients in the control group were treated with routine preoperative fasting scheme, and the ones in the observational group were treated with optimized preoperative fasting scheme. The differences in preoperative duration of water deprivation, intraoperative and postoperative incidences of aspiration, and postoperative first anal exhaust time between the two groups were compared. Results The preoperative duration of water deprivation in the control group was longer than that in the observational group [(12.49±2.63) vs.(6.69±2.76) h, P<0.05]. The incidences of intraoperative and postoperative aspiration were both 0. The postoperative first anal exhaust time in the control group was later than that in the observational group [(11.51±6.58) vs.(8.19±4.13) h, P<0.05]. Conclusions For patients undergoing gynecological day surgery with general anesthesia, the implementation of the optimized preoperative fasting scheme can effectively shorten the preoperative duration of water deprivation, without increasing the risk of anesthesia. It can accelerate the recovery of intestinal function for gynecological laparoscopic day surgery with general anesthesia, promote the implementation of enhanced recovery after surgery, and improve the efficiency of day surgery.

关 键 词：日间手术 妇科 全身麻醉手术 禁饮时间 肛门排气 

分 类 号：R614.2[医药卫生—麻醉学]