Abstract:

Objective To investigate the effect of preoperative fasting on rapid recovery among patients with orthopaedic trauma undergoing elective surgery.Methods A prospective control study was conducted among 144 patients undergoing elective surgery in the department of traumatic orthopaedics in our hospital from January to June 2018,and 75 patients were assigned into in the intervention group and 69 patients in the control group according to the random number table method. In the intervention group,the preoperative fasting procedure was optimized,and maltodextrin and fructose beverages were given according to the preoperative time. The control group used the traditional fasting program at 24：00 a.m. the day before the surgery. The subjective feelings（anxiety,thirst,hunger,nausea,fatigue,dizziness,sweating,and stomach discomfort）,blood sugar and adverse reactions were compared between two groups.Results The average preoperative length of food fasting in the intervention group was（7.6±0.9） h,and in the control group it was （14.4±5.0） h. There was significant difference between two groups（P<0.01）. The average length of water fasting before surgery in the intervention group was （4.5±2.9） h,and that in the control group was（14.3±3.9） h. There was significant difference between two groups（P<0.01）. In terms of subjective feelings,the perioperative anxiety,thirst and stomach discomfort in the intervention group were better than those in the control group（P<0.05）. The blood sugar in the intervention group was significantly higher than that in the control group at 1 hour before surgery（P<0.001）. There were no serious adverse reactions in both groups.Conclusion Preoperative fasting process optimization shortens the length of fasting,improves subjective feelings of patients,and is safe and feasible.

Key words: Orthopaedic Trauma, Fasting, Water Deprivation, Preoperative Care, Intervention Studies

摘要：

目的 探讨优化术前禁食禁饮流程对创伤骨科择期手术患者快速康复的影响。方法 选取我院创伤骨科2018年1月—6月择期手术患者144例,依据随机数字表法分为试验组75例和对照组69例进行前瞻性对照研究。试验组采用术前禁食禁饮优化流程,根据患者预排手术时间,术前分时段给予麦芽糊精果糖饮品。对照组采用传统的手术前1 d 24：00开始禁食禁饮方案。比较两组主观感受（焦虑、口渴、饥饿、恶心、疲劳、头晕、虚汗及胃部不适）、血糖及不良反应的发生情况。结果 术前禁食时间：试验组（7.6±0.9） h,对照组（14.4±5.0） h,两组差异具有统计学意义（P<0.01）;术前禁饮时间：试验组（4.5±2.9） h,对照组（14.3±3.9） h,两组差异具有统计学意义（P<0.01）。主观感受方面,试验组围手术期焦虑、口渴和胃部不适情况均优于对照组（P<0.05）。试验组术前1 h血糖值明显高于对照组,差异有统计学意义（P<0.001）。两组均未发生严重不良反应。结论 优化术前禁食禁饮流程缩短了患者术前禁食禁饮时间,患者主观感受得到改善,且安全可行。

关键词: 创伤骨科, 禁食, 禁水, 手术前护理, 干预性研究