摘要
目的:系统评价新指南术前禁食禁饮时间的临床效果和安全性.方法:计算机检索中国知识资源总库、万方数据库、中国生物医学文献数据库、西文生物医学期刊文献数据库、Cochrane图书馆、Pubmed等数据库,查找自建库以来至2014-07国内外关于择期手术术前禁食禁饮时间的随机对照研究(randomized controlled trials,R C T).按照纳入与排除标准选择文献、提取资料、评价质量后,采用Rev Man5.1软件进行Meta分析.结果:共纳入7个RCT研究,1623例患者,其中传统组808例,新指南组815例.Meta分析结果显示:对于择期手术的患者而言遵循新指南进行术前禁食禁饮,可显著减少患者术前饥饿发生率(RR=0.35,95%CI:0.23-0.54,P<0.00001),减轻口渴发生率(R R=0.25,95%C I:0.15-0.40,P<0.00001),还能缓解患者的焦虑情绪(RR=0.26,95%CI:0.09-0.69,P=0.007),但降低术后恶心(R R=0.92,95%C I:0.73-1.16,P=0.49)、呕吐(R R=0.81,95%CI:0.58-1.13,P=0.23)发生率的效果并不显著.结论:与择期手术前传统禁食禁饮时间相比,新方案能减少患者术前饥饿感,降低口渴程度,减轻患者焦虑,建议临床推广使用,由于纳入研究样本量小,上述结论尚需要高质量、大样本的随机双盲对照试验加以证实.
AIM： To assess the impact of reduced preoperative fasting time on safety and efficacy in elective surgical patients.METHODS： Randomized controlled trials（RCTs） of preoperative fasting time in elective surgical patients were searched and retrieved through databases including CNKI, Wan Fang Data, China Biology Medicine disc（CBM）, Foreign Medical Journal Full-Text Service（FMJS）, Cochrane Library and PubMed. RevMan 5.1 software was used for Meta-analysis. RESULTS： Seven RCTs involving 1623 patients were included. Meta-analysis showed that less preoperative hunger（RR = 0.35, 95%CI： 0.23-0.54, P〈0.00001）, thirst（RR = 0.25, 95%CI： 0.15-0.40, P〈0.00001）, and anxiety（RR = 0.26, 95%CI： 0.09-0.69, P = 0.007） were reported by those who had a shorter fast; however, it could not reduce the incidence of nausea（RR = 0.92, 95%CI： 0.73-1.16, P = 0.49） and vomiting（RR = 0.81, 95%CI： 0.58-1.13, P = 0.23） after the operation.CONCLUSION： Compared with traditional preoperative fasting, implementation of reduced preoperative fasting can reduce preoperative hunger, thirst and anxiety, but has no significant impact on the incidence of postoperative nausea and vomiting.
出处
《世界华人消化杂志》
CAS
2015年第3期515-520,共6页
World Chinese Journal of Digestology
