CAJ | 학술논문

目的：探讨颈椎全麻术后患者首次饮水、进食的适宜时间。方法选择2011年1月～2013年12月在我科行颈椎手术的829例全麻术后患者作为研究对象，排除上颈髓损伤、生命体征不稳定、术后2 h内出现恶心呕吐症状者，以入院单双号随机分为观察组416人、对照组413人。观察组术后30 min ，患者意识清醒，即可饮用少于50ml温凉开水或盐水，术后2h进流质或半流质饮食；对照组于术后6h进饮食。分别于术后2h、5h评估两组患者口渴、饥饿、咽喉不适、恶心、呕吐、腹胀等不适情况，餐后2h恶心、呕吐及腹胀的发生率，以及进饮食时误吸的发生率，并进行比较。结果术后2 h口渴、咽喉不适者对照组高于观察组（P＜0．01）；术后5 h口渴、咽喉不适、饥饿感对照组较术后2h在者和程度上明显增加，观察组人数减少，两组比较，差异有显著意义；餐后2h对照组腹胀者显著高于观察组，差异有显著意义（P＜0．01）；两组患者均未发生误吸现象。结论颈椎全麻术后，在患者完全清醒的情况下，提早进饮食是安全、可行的，有利于术后患者胃肠功能恢复，并能增加患者术后的舒适感。
목적：탐토경추전마술후환자수차음수、진식적괄의시간。방법선택2011년1월～2013년12월재아과행경추수술적829례전마술후환자작위연구대상，배제상경수손상、생명체정불은정、술후2 h내출현악심구토증상자，이입원단쌍호수궤분위관찰조416인、대조조413인。관찰조술후30 min ，환자의식청성，즉가음용소우50ml온량개수혹염수，술후2h진류질혹반류질음식；대조조우술후6h진음식。분별우술후2h、5h평고량조환자구갈、기아、인후불괄、악심、구토、복창등불괄정황，찬후2h악심、구토급복창적발생솔，이급진음식시오흡적발생솔，병진행비교。결과술후2 h구갈、인후불괄자대조조고우관찰조（P＜0．01）；술후5 h구갈、인후불괄、기아감대조조교술후2h재자화정도상명현증가，관찰조인수감소，량조비교，차이유현저의의；찬후2h대조조복창자현저고우관찰조，차이유현저의의（P＜0．01）；량조환자균미발생오흡현상。결론경추전마술후，재환자완전청성적정황하，제조진음식시안전、가행적，유리우술후환자위장공능회복，병능증가환자술후적서괄감。
Objective To study the suitable first time for eating and drink for patients after cervical general anes-thesia .Method 829 hospitalized patients with general anesthesia for cervical surgery from January 2011 to December 2013 in our hospital were selected for the study .Patients with such symptom ,such as upper cervical spinal cord in-jury ,unstable vital signs ,vomiting and nausea 2 hours after surgery ,was not included in this study .416 patients in observation group ,413 patients in control group .Patient with waking consciousness in observation group was given 50 ml warm water or light salt water 30 min after surgery ,Liquid or semi-liquid diet was given 2 hours after surger-y .patients in control was given diet 6 hours after surgery .The symptom of thirst ,hunger ,throat discomfort ,bloa-ting ,vomiting and nausea 2 hours after surgery was evaluated .the incidence of bloating ,vomiting and nausea 2 hours after diet ,and the incidence of aspiration when eating was observed and compared for the two group .Result The incidence of throat discomfort and thirst 2 hours after surgery in control group was higher than that of observa-tion group (P<0 .01) .The extent and number of throat discomfort ,thirst and hunger 5 hours after surgery in con-trol group was increased compared with observation group .there was significant difference between the two group . The number of bloating 2 hours after diet in control group was higher than that of observation group (P<0 .01) .No aspiration was found in both group .Conclusion It’s feasible and safe for early eating for patient with waking con-sciousness after cervical general anesthesia .It’s benefit for the recovery of gastrointestinal function and improving the patients’ postoperative comfortable .