术前口服碳水化合物用于胃镜检查患儿的效果

钱望月; 朱伟伟

doi:10.7619/jcmp.20220726

术前口服碳水化合物用于胃镜检查患儿的效果

Effect of preoperative oral administration of carbohydrate in children undergoing gastroscopy

摘要

摘要:
目的评估术前口服碳水化合物用于胃镜检查患儿的效果。
方法选取2019年6月—2021年6月行胃镜检查的80例患儿为研究对象，按照随机数字表将患儿分为碳水化合物组(C组)或常规禁食、禁水组(S组)，每组40例。2组各有2例患儿监护人术前要求退出本研究，最终纳入患儿76例，每组38例。C组患儿于术前6 h开始禁食固体食物，于术前2 h口服碳水化合物5 mL/kg, 总量≤300 mL。S组患儿术前6 h开始禁食固体食物，术前2 h口服清水5 mL/kg, 总量≤300 mL。记录术后24 h内患儿恶心、呕吐、寒战、头晕等不良反应发生情况。胃镜检查开始后抽取胃内容物，并测量胃内容物的量和胃内容物pH值。
结果 C组患儿术前饥饿发生率低于S组，内容物的量少于S组，差异有统计学意义(P < 0.05)。2组患儿胃内容物pH值比较，差异无统计学意义(P>0.05); 2组胃内容物≤0.5 mL/kg、>0.5~1.0 mL/kg、>1.0~1.5 mL/kg患儿占比比较，差异无统计学意义(P>0.05)。C组胃内容物>1.5 mL/kg患儿占比为5.3%, 低于S组的21.1%, 差异有统计学意义(P < 0.05); C组患儿术后恶心、寒战发生率分别为26.3%、21.1%, 低于S组的50.0%、44.7%, 差异有统计学意义(P < 0.05)。
结论术前口服碳水化合物能够明显改善患儿术前口渴、饥饿症状，并能促进胃排空，降低术后恶心和寒战发生率。

Abstract:
Objective To evaluate the effect of preoperative oral administration of carbohydrate in children undergoing gastroscopy.
Methods A total of 80 children who underwent gastroscopy from June 2019 to June 2021 were selected as study objects. The children were divided into carbohydrate group (group C) and routine fasting and water prohibition group (group S) according to the random number table method, with 40 cases in each group. There were two children in each group who withdrew from the study before surgery, and 76 children were finally included, with 38 in each group. The children in the group C were prohibited for solid food 6 h before operation, and orally took carbohydrate 5 mL/kg 2 h before operation, with the total amount ≤300 mL. Children in the group S were prohibited for solid food 6 h before operation, and the total amount of water was orally taken for less than 300 mL (5 mL/kg). Nausea, vomiting, chills, dizziness and other adverse reactions were recorded within 24 hours after operation. After the start of gastroscopy, gastric contents were extracted, and the amount of gastric contents and pH value of gastric contents were measured.
Results The incidence of preoperative starvation in the group C was lower than that in the group S, and the amount of contents was less than that in the group S, and the differences were statistically significant (P < 0.05). There was no significant difference in pH value of gastric contents between the two groups (P>0.05). There were no significant differences in the proportions of children with stomach contents ≤0.5 mL/kg, >0.5 to 1.0 mL/kg, and >1.0 to 1.5 mL/kg between the two groups (P>0.05). The proportion of children with gastric contents >1.5 mL/kg in the group C was 5.3%, which was lower than 21.1% in the group S, and the difference was statistically significant (P < 0.05). The incidence rates of postoperative nausea and chills in the group C were 26.3% and 21.1%, respectively, which were lower than 50.0% and 44.7% in the group S (P < 0.05).
Conclusion Preoperative oral administration of carbohydrate can significantly improve the symptoms of thirst and hunger, promote gastric emptying, and reduce the incidence of postoperative nausea and shivering.

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