2018 年第 10 期 第 13 卷

术前禁食时间延长对外科重症患者术中及术后情况的影响

Influence of preoperative prolonged fasting time on intraoperative and postoperative condition in critical patients

作者：周刚朱凤雪安友仲

英文作者：

单位：100044北京大学人民医院创伤救治中心及重症医学科

英文单位：

关键词：外科手术；术前禁食时间；应激反应

英文关键词：

• 摘要：

• 【摘要】目的    探讨术前禁食时间对外科重症患者术中及术后情况的影响。方法    回顾性选取2016年6—9月于北京大学人民医院外科术后带气管插管返回重症监护病房（ICU）患者76例，均为择期开腹手术患者，按照术前禁食时间是否延长分为常规时间组（41例，术前晚22：00禁食至手术当日清晨8：00）和时间延长组（35例，术前晚22：00禁食至手术当日中午12：00以后）。比较2组患者基本资料及术中和术后情况。结果    2组患者手术时间、术中失血量、术中输血比例、术中尿量比较，差异均无统计学意义（均P＞0.05）。常规时间组术后心肌损伤和术后外科相关并发症发生率明显低于时间延长组［4.9%(2/41)比22.9%(8/35)、4.9%(2/41)比20.0%(7/35)］，差异均有统计学意义（均P＜0.05）。结论    术前禁食时间延长增加外科重症患者术后并发症的发生及重要器官损伤，应尽量避免延长术前禁食时间。

• 【Abstract】Objective    To analyze the influence of preoperative prolonged fasting time on the intraoperative and postoperative condition in critically ill patients. Methods    A total of 76 post-laparotomy patients with endotracheal intubation admitted to the Intensive Care Unit of Peking University People′s Hospital from June 2016 to September 2016 were retrospectively included. According the duration time of preoperative fasting, the patients were divided into regular fasting time group（≥10 h, n＝41） and prolonged fasting time group（≥14 h, n＝35）. Basic clinical data, intraoperative and postoperative records were analyzed. Results    There was no statistically significant difference between the two groups in operation time, intraoperative blood loss, intraoperative blood transfusion ratio and intraoperative urine volume（all P＞0.05）. Incidences of postoperative myocardial injury and surgical complications in the normal fasting time group were significantly lower than those in the prolonged fasting time group［4.9%(2/41) vs 22.9%(8/35), 4.9%(2/41) vs 20.0%(7/35)］（both P＜0.05）. Conclusion    Prolonged preoperative fasting time may increase postoperative complications and vital organ damage in critical patients.