摘要
目的:探讨术前2 h口服碳水化合物对择期剖宫产术后早期母乳喂养的影响。方法:选取80例择期行剖宫产的初产妇随机分为观察组和对照组,各40例。对照组术前禁食12 h,禁饮8 h,观察组术前2 h口服12.5%碳水化合物400 m L。采用视觉模拟评分法(Visual Analogue Scale,VAS)评估术前3 h,30 min饥饿、口渴、焦虑水平,对比术前3 h、术后1 d胰岛素抵抗指数(homeostasis model assessment-insulin resi stance,HOM A-I R)和泌乳素水平,观察术后首次成功母乳喂养时间、术后24 h母乳喂养次数和持续时间。结果:观察组术前30 min口渴、饥饿、焦虑VA S评分显著低于对照组(P<0.01)。观察组术后24 h HOMA-IR指数显著低于对照组,术后1 d泌乳素水平显著高于对照组(P<0.05)。观察组首次成功母乳喂养时间显著早于对照组,术后24 h母乳喂养次数和持续时间显著大于对照组(P<0.01)。结论:术前2 h口服碳水化合物可以减轻择期剖宫产产妇生理和心理应激,改善围手术期主观不适感和胰岛素抵抗,提高术后早期母乳喂养水平。
Objective： To investigate the effect of oral carbohydrates 2 h before operation on early breastfeeding after elective cesarean section. Methods： Eighty primiparas undergoing selected cesarean section were randomly divided into an observation group and a control group, with 40 cases in each group. In the control group, no drink was given during the period of 8 hours before the operation, and 400 m L of 12.5% carbohydrate was taken in the observation group 2 hours before the surgery. The level of thirst, hunger, and anxiety were evaluated by Visual Analogue Scale（VAS） at 3 h, and 30 min before operation. The insulin resistance index and prolactin was detected at the time points at 3 hours before operation and 1 day after operation. The first successful breastfeeding time, and the number and duration of breastfeeding in 24 h after operation were recorded and compared. Results： The VAS score of thirsty, hunger, and anxiety in the observation group was significantly lower than the control group（P〈0.01）. The postoperative homeostasis model assessment-insulin resistance（HOMA-IR） index was significantly lower, and the postoperative prolactin was significantly higher in the observation group（P〈0.05）. The first successful breastfeeding time in the observation group was significantly earlier than the control group, the frequency and duration of breastfeeding during the postoperative 24 h were significantly greater than the control group（P〈0.01）. Conclusion： Oral carbohydrate 2 hours before elective cesarean section can reduce the physiological and psychological stress, alleviate the perioperative subjective discomfort and insulin resistance, and improve the quality of early breastfeeding.
作者
苏雅漩
陈娜芬
苏艺娟
殷婷婷
SU Yaxuan;CHEN Nafen;SU Yijuan;YIN Tingting(Department of Pediatrics,the 174th Hospital of People＇s Liberation Army,Xiamen Fujian 361000,China)
出处
《临床与病理杂志》
2018年第6期1261-1266,共6页
Journal of Clinical and Pathological Research
基金
厦门医学院教学研究专项课题(J2013-32-12)~~
关键词
剖宫产
口服碳水化合物
母乳喂养
应激
cesarean section
oral carbohydrates
breastfeeding
stress
