摘要
目的探讨耳鼻咽喉-头颈外科手术患者全身麻醉后的禁食时间,为患者尽早进食提供护理依据。方法将180例择期全麻手术患者按手术部位均分为对照组和观察组各90例。对照组按照常规护理,即患者麻醉清醒6h后开始进食;观察组根据手术部位及手术和麻醉时间的长短,在患者意识清醒且吞咽功能恢复的前提下首先饮少量温开水,如无误咽现象即可进食流质或半流质。比较两组首次进食时间、误吸率、餐前血糖值及患者口渴、饥饿等不适发生率。结果观察组不同手术部位患者进食时间显著缩短(均P<0.01),误吸发生率与对照组比较,差异无显著性意义(均P>0.05),餐前血糖值(除外头颈部手术患者)显著高于对照组(P<0.05,P<0.01),口渴、饥饿、胃不适等发生率显著低于对照组(P<0.01)。结论耳鼻咽喉-头颈外科手术患者在其意识完全清醒且吞咽功能恢复的前提下提前进食,可以缓解患者不适症状,避免血糖降低。
Objective To study how long patients receiving otolaryngology or head-neck surgery should refrain from oral intake and fluid intake after general anesthesia, and to provide guidedance to clinical nursing work. Methods A total of 180 patients were randomly divided into a control group and an observation group with 90 cases in each group. Patients in the control group were allowed to take food orally 6 h after they emerged from anesthesia, while the observation group were encouraged to drink small amount of luke warm water at emergence from anesthesia if the swallowing function returned according to operated site, and the length of the operation and anesthesia, then they were allowed to swift to liquid or semi-liquid food if no deglutition was noted. Results The length of fasting in the observation group was significantly shortened （P〈0.01 for all）. The fasting plasma glucose level was significantly higher in the observation group （P〈0.05, P〈0.01）, and the rates of thirst, hunger, gastric upset were significantly lower in the observation group （P〈0.01）. Conclusion For patients undergoing otolaryngotogy or head-neck surgery, in order to relieve uncomfortable symptoms, prevent hypoglycemia and promote recovery, early postoperative feeding should be suggested on the premise that they are fully awake and their swallowing function returned.
基金
广西壮族自治区卫生厅医疗自筹经费科研立项计划(Z2007063)
关键词
耳鼻咽喉-头颈手术
全身麻醉
进食时间
误咽
低血糖
otolaryngology and head-neck surgery
general anesthesia
time to eat
deglutition
hypoglycemia
