摘要
目的评估妇科良性疾病腹腔镜术前行机械性肠道准备(mechanical bowel preparation, MBP)的必要性。方法采用前瞻性随机单盲对照研究。将160例入选患者按随机数字表随机分为两组:研究组术前日行低渣饮食,对照组于术前日行MBP(14:00起口服溶有复方聚乙二醇电解质散剂的溶液2 000 ml)。采用视觉模拟量表(visual analogue scale, VAS)评估患者术前胃肠道不适,Likert量表(4分制)评估术野暴露情况。结果术前日对照组腹胀、肛门刺激症状及愿意尝试其他方法进行肠道准备的VAS评分[分别为0(0, 4)分、0(0, 4)分、5(0, 8)分]较研究组明显增高[0(0, 1)分、0(0, 1)分、2(0, 5)分](P <0.05)。术中对照组小肠、大肠的准备效果及肠管拨动便利度"好"或"极好"的比例(36.25%、47.50%、41.25%)高于研究组(16.25%、23.75%、21.25%),两组比较,差异有统计学意义(P <0.05)。研究组在手术开始及结束时术野暴露情况、子宫直肠陷凹暴露效果"好"或"极好"的比例(66.25%、70.00%、63.75%)与对照组(77.50%、76.25%、76.25%)比较,差异均无统计学意义(P>0.05)。结论妇科良性疾病腹腔镜术前不必常规进行机械性肠道备。
Objective To evaluate the necessity of mechanical bowel preparation(MBP) before benign gynecologic laparoscopic surgeries. Methods This was a prospective, single-blind, randomized controlled study. A total of 160 patients were randomly divided into two groups: the study group had a low-residue diet the day before operation, the control group had a MBP in the day before operation(polyethylene glycol electrolyte powder, added 2 000 ml warm boiled water in it, and drunk it from 14:00). A visual analogue scale(VAS) score was used to evaluate gastrointestinal discomfort, a five-point scale was used to evaluate the quality of the surgical field. Results The VAS scores of the abdominal bloating, anal irritation and willingness to try another preparation in the control group [0(0, 4) points;0(0, 4) points;5(0, 8) points] were significantly increased than those of the study group [0(0, 1) points;0(0, 1) points;2(0, 5) points](P < 0.05) on preoperative day. The proportions of "good" or "excellent" in the large bowel preparation, the small bowel preparation and the convenience of bowel handling were statistically higher in the control group(36.25%, 47.50% and 41.25%) than those of the study group(16.25%, 23.75% and 21.25%)(P < 0.05),but there were no statistical differences in the proportions of "good" or "excellent" in the visual field at start and end and the visualization of posterior cul de sac in the study group(66.25%, 70.00%, 63.75%) compared with the control group(77.50%,76.25%, 76.25%)(P > 0.05). Conclusion It is not necessary to perform routine mechanical bowl preparation before benign gynecologic laparoscopic surgeries.
作者
方庭枫
胡琦玥
朱玉叶
钟晓珠
谢梅青
丁淼
FANG Tingfeng;HU Qiyue;ZHU Yuye;ZHONG Xiaozhu;XIE Meiqing;DING Miao(Department of General Gynecology,Sun-Yat Sen Memorial Hospital,Sun-Yat Sen University,Guangzhou 510120,China)
出处
《中国妇产科临床杂志》
CSCD
2021年第6期593-596,共4页
Chinese Journal of Clinical Obstetrics and Gynecology
关键词
机械性肠道准备
腹腔镜手术
妇科良性疾病
mechanical bowl preparation
laparoscopy surgery
gynecological benign disease
