CAJ | 학술논문

目的：探讨术前口服糖盐溶液对腹腔镜胆囊切除术患者健康的安全性。方法将178例行腹腔镜胆囊切除术患者随机分为观察组和对照组各89例，对照组采用术前常规禁食方式，即术前1 d 10∶00 pm禁食12 h，术日6∶00 am禁饮4 h；观察组于术前1 d 10∶00 pm研究者指导患者口服自制糖盐溶液300 ml，12∶00 pm后禁饮禁食，术前4 h再饮糖盐溶液200 ml。采用直观标度尺评分（ VAS）测量患者术前主观不适感；比较术前1d晨、术日晨、术后6h、12h、24h血糖、心率、血压变化。结果对照组不同时刻所测得的血糖、心率、收缩压及舒张压存在差别（ F＝5.609、5.771、15.780、12.335， P＜0.05），而观察组各时刻生理指标变化不显著（ P＞0.05）；且血糖术后24h、心率术后6h、收缩压术后6h及舒张压术后6h时刻点与其他时刻点差异均有统计学意义（P＜0.05），两组测得的血糖、心率、收缩压及舒张压比较差异无统计学意义（P＞0.05）；两组患者术前1 d晨VAS总分及各因子得分无显著差异（ P＞0.05），术日晨对照组患者主要不适感觉为紧张、饥饿、口渴、疲劳、疼痛， VAS总分与观察组相比均显著增加（ P＜0.05）。结论采用自制口服糖盐溶液于术前1 d 10∶00 pm及术前4 h饮用糖盐溶液，不影响腹腔镜胆囊切除术患者围术期生命体征的稳定及麻醉插管，不增加术中误吸与术后肺炎的发生率，同时可以减轻患者术前饥饿、口渴感，缓解紧张、疲劳、疼痛感；维持术前血糖稳定。
목적：탐토술전구복당염용액대복강경담낭절제술환자건강적안전성。방법장178례행복강경담낭절제술환자수궤분위관찰조화대조조각89례，대조조채용술전상규금식방식，즉술전1 d 10∶00 pm금식12 h，술일6∶00 am금음4 h；관찰조우술전1 d 10∶00 pm연구자지도환자구복자제당염용액300 ml，12∶00 pm후금음금식，술전4 h재음당염용액200 ml。채용직관표도척평분（ VAS）측량환자술전주관불괄감；비교술전1d신、술일신、술후6h、12h、24h혈당、심솔、혈압변화。결과대조조불동시각소측득적혈당、심솔、수축압급서장압존재차별（ F＝5.609、5.771、15.780、12.335， P＜0.05），이관찰조각시각생리지표변화불현저（ P＞0.05）；차혈당술후24h、심솔술후6h、수축압술후6h급서장압술후6h시각점여기타시각점차이균유통계학의의（P＜0.05），량조측득적혈당、심솔、수축압급서장압비교차이무통계학의의（P＞0.05）；량조환자술전1 d신VAS총분급각인자득분무현저차이（ P＞0.05），술일신대조조환자주요불괄감각위긴장、기아、구갈、피로、동통， VAS총분여관찰조상비균현저증가（ P＜0.05）。결론채용자제구복당염용액우술전1 d 10∶00 pm급술전4 h음용당염용액，불영향복강경담낭절제술환자위술기생명체정적은정급마취삽관，불증가술중오흡여술후폐염적발생솔，동시가이감경환자술전기아、구갈감，완해긴장、피로、동통감；유지술전혈당은정。
Objective To evaluate the effect of the preoperative oral sugar salt solution on patients with lapa -roscopic gallbladder excision.Methods A total of 178 patients with laparoscopic gallbladder excision were divided into observation group and control group with 89 cases in each.The control group adopted routine fasting way before opera-tion.The patients in the observation group were treated with 300 ml of the sugar salt solution at the 10 o'clock on the evening before surgery.After midnight, nothing by mouth was allowed, except a single morning dose of 200 ml of the corresponding solution.The morning drink was taken at 2h before surgery.Visual analog scales ( VAS) were used to score 11 different preoperative discomfort variables.Operational clinical and surgical data were recorded, which included the blood pressure, heart rate, blood glucose levels.Results The control group at different time measured blood glu-cose, heart rate, systolic pressure and diastolic pressure were statistically different ( F=5.609, 5.771, 15.780, 12.335 , P<0.05 ) , While the observation group each time physiological indexes had no significant change ( P>0.05) .And blood glucose after 24h, the heart rate after 6h, blood pressure after 6h time compared with other time points statistically significant differences ( P<0.05) .The heart rate, systolic pressure, diastolic pressure, blood glu-cose levels were not statistically different between the two groups ( P>0.05) .On the morning before surgery, patients in the control group mainly unwell feeling nervous, hunger, thirst, fatigue, pain, VAS score were significantly increased than those in the observation group ( P<0.05 ) .Conclusions Drinking the sugar salt solution at the 10 o'clock on the evening before surgery and 2 h before surgery does not affect anesthesia intubation.and not increase the risk of regurgita-tion and aspiration during or after surgery and alleviatenervous, hunger, thirst, fatigue, pain.