摘要
目的调查了解我国创伤骨科择期手术患者(含合并糖尿病患者)围手术期饮食管理现状及医生认知程度。方法2021年11月1日至12月31日期间,通过微信在全国加速康复外科(ERAS)交流群和北京积水潭医院创伤骨科全国进修医生交流群中推送调查问卷,调查内容包括:不合并糖尿病患者术前禁水时间、术后恢复进水时间,医生选择围手术期饮食管理的依据,医生对现有指南的了解程度,合并糖尿病患者术前禁水、术后恢复饮水的时间及糖尿病相关的问题,以及所有患者术后恢复进食的时间(对于术后恢复进食问题,没有区分是否合并糖尿病)。分析医生的有关职业信息与其选择管理策略的依据及对指南了解程度的关系。结果共收回565份有效问卷。对于不合并糖尿病的患者,要求术前至少禁水2 h的比例为12.92%(73/565),实际从手术当日0时开始禁水的比例仍然最高,为24.07%(136/565);选择"一旦清醒即可进水"的比例为22.83%(129/565),选择术后至少6 h恢复进水的比例为42.12%(238/565)。要求所有患者术前至少禁食6 h的比例为33.98%(192/565),选择"进水后无不适反应后2 h恢复进食"的比例为44.25%(250/565)。21.06%(119/565)的医生表示对指南相当了解且根据指南的要求进行围手术期饮食管理。对于合并糖尿病患者的禁水管理更加不统一,较多的医院倾向于传统的禁水原则,选择手术当日0时、术前8 h、术前6 h和术前4 h开始禁水分别占22.83%(129/565)、19.12%(108/565)、21.95%(124/565)、18.94%(107/565)。医生所在医院级别和医生职称是医生对指南了解程度的相关因素(P<0.05)。结论我国创伤骨科围手术期饮食管理指南执行率及知晓率均较低。合并糖尿病患者的围术期饮食管理流程亟待优化。
Objective To investigate the current situation of perioperative fasting management in patients with orthopaedic trauma waiting for elective surgery(those combined with diabetes mellitus included)and the surgeons'awareness in China.Methods From November 1st to December 31st,2021,the questionnaire forms were distributed through WeChat in the exchange group of National Enhanced Recovery Surgery(ERAS)and the exchange group of national training orthopaedists in Beijing Jishuitan Hospital.The survey contents included:time for preoperative water deprivation and for postoperative recovery of drinking in patients without diabetes mellitus,the rationales for orthopaedists to choose perioperative dietary management,the orthopaedists'understanding of the existing guidelines,time for preoperative water deprivation and postoperative recovery of drinking and diabetes-related issues in patients with diabetes mellitus,and the time for postoperative recovery in all the patients(For the postoperative recovery of eating,there is no difference between patients with and without diabetes mellitus).The relationships were analyzed between some professional data of the orthopaedists and their rationales for choice of management strategies and their understanding of the guidelines.Results A total of 565 valid questionnaires were collected.12.92%(73/565)of orthopaedists required their patients without diabetes mellitus not to drink for at least 2 hours.In fact,the proportion of water prohibition from 0 o'clock on the day of operation was still the highest[24.07%(136/565)].Respectively,22.83%(129/565)and 42.12%(238/565)of the orthopaedists chose"water intake is allowed once awakened"and"water intake after at least 6 hours after operation"for their patients without diabetes mellitus.33.98%(192/565)of the orthopaedists required all the patients fasted for at least 6 hours before surgery,and 44.25%(250/565)of the orthopaedists chose"eating can be resumed if there is no discomfort for 2 hours after water intake".21.06%(119/565)of the orthopaedis
作者
孙旭
孙志坚
姚东晨
迟春梅
李庭
吴新宝
Sun Xu;Sun Zhijian;Yao Dongchen;Chi Chunmei;Li Ting;Wu Xinbao(Department of Orthopaedic Trauma,Beijing Jishuitan Hospital,Beijing 100035,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2022年第8期666-672,共7页
Chinese Journal of Orthopaedic Trauma
基金
首都卫生发展科研专项(首发2018-2-2073)。
关键词
创伤和损伤
糖尿病
禁水
禁食
问卷调查
Wounds and injuries
Diabetes mellitus
Water deprivation
Fasting
Questionnaire
