摘要
目的 观察加速康复外科(ERAS)理念下优化禁食、禁饮时间对Mako机器人辅助全膝关节置换术患者的影响。方法 选取该院2021年4月至2022年3月在全身麻醉下行Mako机器人辅助全膝关节置换术的患者109例,分为对照组51例和观察组58例。对照组采用常规禁食、禁饮方法;观察组根据患者手术台次安排给予不同时间段口服碳水化合物饮料(每次200 mL),手术前一天晚上统一口服强化营养液200 mL。记录患者术前饥饿口渴程度、术中反流误吸情况、术后24 h内恶心呕吐发生率、术前术后血糖变化情况及术前术后的红细胞比容(HCT)。结果 2组患者性别、年龄、BMI等一般资料比较差异无统计学意义(P>0.05)。2组患者术前禁食、禁饮时间及口渴饥饿程度差异有统计学意义(P<0.05)。2组患者围术期均未发生反流误吸,对照组术后24 h内恶心呕吐发生率[17例(33.3%)]高于观察组[3例(5.2%)],差异有统计学意义(P<0.05)。对照组术后血糖、术后24 h HCT高于观察组,差异有统计学意义(P<0.05)。结论 优化Mako机器人辅助全膝关节置换术患者术前禁食、禁饮时间,可有效减轻患者术前口渴、饥饿,术后恶心呕吐的发生,有利于血液得到稀释,且术前术后血糖波动范围小,对于合并糖尿病的患者更有益处,加速了患者术后康复进程。
Objective To observe the effect of optimizing fasting and drinking time on patients undergoing Mako robot-assisted total knee arthroplasty under the concept of ERAS.Methods A total of 109 patients undergoing Mako robot-assisted total knee arthroplasty under general anesthesia in our department from April 2021 to March 2022 were selected and divided into the control group(n=51) and the observation group(n=58).The control group used conventional fasting and drinking methods.The observation group was given 200 mL of oral carbohydrate beverage at different time periods according to the patient's operation schedule,and 200 mL of oral fortified nutrition solution was given in the evening before the operation.The degree of hunger and thirst before operation,intraoperative reflux and aspiration,the incidence of nausea and vomiting within 24 hours after operation,and changes of blood glucose before and after operation,and the hematocrit(HCT) before and after operation were recorded.Results There was no significant difference in gender,age,BMI and other general data between the two groups(P>0.05).There were significant differences in preoperative fasting,fasting time and degree of thirst and hunger between the two groups(P<0.05).There was no reflux aspiration in the two groups during the perioperative period.The incidence of nausea and vomiting within 24 hours after operation in the control group [17 cases(33.3%)] was higher than that in the observation group [3 cases(5.2%)],and the difference was statistically significant(P<0.05).There was significant difference in blood glucose after operation anc HCT after 24 hours operation between the two groups before and after operation(P<0.05).Conclusion Optimizing the time of preoperative fasting and drinking in patients undergoing Mako robot-assisted total knee arthroplasty can effectively reduce the occurrence of preoperative thirst,hunger,postoperative nausea and vomiting,which is conducive to blood dilution,and the range of blood glucose fluctuations before and after surgery i
作者
王蕾
何红艳
南少奎
柴伟
程凌燕
孔祥朋
WANG Lei;HE Hongyan;NAN Shaokui;CHAI Wei;CHENG Lingyan;KONG Xiangpeng(Department of Joint Surgery,Section of Orthopaedics,the Fourth Medical Center of Chinese PLA General Hospital,Beijing100048,China)
出处
《重庆医学》
CAS
2023年第24期3718-3722,共5页
Chongqing medicine
基金
国家骨科与运动康复临床医学研究中心转化项目(2021-NCRC-CXJJ-ZH-01)。
