目的:为了研究与分析剖宫产术前禁饮对产妇安全性及舒适度的影响情况。方法:选入我院从2020年9月到2022年3月以来接收的择期手术的剖宫产产妇作为研究对象,抽样90例患者,产妇均经随机数字表法进行分组,分别分为A组、B组、C组,各30例,A组应用传统禁食禁饮方法,B组术前禁食,术前2小时予以200 ml清水口服,C组禁食,术前2小时予以10%葡萄糖溶液200 ml服用,通过比较与分析,探讨对剖宫产术前禁饮对产妇安全性及舒适度的影响情况。结果:C组的满意度和舒适度显著高于其他两组的满意度和舒适度,差异具有统计学意义(p < 0.05)。结论:剖宫产术前2小时口服碳水化合物对产妇的血糖影响,产妇误吸,产妇的舒适感,以及胎儿的健康状况有着非常明显的效果。 Objective: In order to study and analyze the influence of drinking prohibition before cesarean sec-tion on the safety and comfort of parturients. Method: We selected the cesarean section parturients who received elective surgery in our hospital from September 2020 to March 2022 as the research object, and sampled 90 patients. The parturients were divided into group A, group B, and group C by random number table, with 30 cases in each group. Group A applied the traditional fasting and drinking methods, while group B fasted before surgery, taking 200 ml of clean water 2 hours before surgery, fasting in group C, and taking 200 ml of 10% glucose solution 2 hours before surgery. Through comparison and analysis, this paper explores the influence of drinking prohibition before cesarean section on the safety and comfort of parturients. Result: The satisfaction and comfort of group C was significantly higher than that of the other two groups, and the difference was statisti-cally significant (p < 0.05). Conclusion: The influence of oral carbohydrate 2 hours before cesarean section on the blood sugar of the parturient, the aspiration of the parturient, the comfort of the parturient, and the health of the fetus has very obvious effects.
目的:为了研究与分析剖宫产术前禁饮对产妇安全性及舒适度的影响情况。方法:选入我院从2020年9月到2022年3月以来接收的择期手术的剖宫产产妇作为研究对象,抽样90例患者,产妇均经随机数字表法进行分组,分别分为A组、B组、C组,各30例,A组应用传统禁食禁饮方法,B组术前禁食,术前2小时予以200 ml清水口服,C组禁食,术前2小时予以10%葡萄糖溶液200 ml服用,通过比较与分析,探讨对剖宫产术前禁饮对产妇安全性及舒适度的影响情况。结果:C组的满意度和舒适度显著高于其他两组的满意度和舒适度,差异具有统计学意义(p < 0.05)。结论:剖宫产术前2小时口服碳水化合物对产妇的血糖影响,产妇误吸,产妇的舒适感,以及胎儿的健康状况有着非常明显的效果。
禁饮,剖宫产,安全性,舒适度
Lixia Huang, Xiaoqing Zhang, Jiangping Huang
Department of Obstetrics, Yiwu Central Hospital, Yiwu Zhejiang
Received: Sep. 19th, 2022; accepted: Oct. 11th, 2022; published: Oct. 20th, 2022
Objective: In order to study and analyze the influence of drinking prohibition before cesarean section on the safety and comfort of parturients. Method: We selected the cesarean section parturients who received elective surgery in our hospital from September 2020 to March 2022 as the research object, and sampled 90 patients. The parturients were divided into group A, group B, and group C by random number table, with 30 cases in each group. Group A applied the traditional fasting and drinking methods, while group B fasted before surgery, taking 200 ml of clean water 2 hours before surgery, fasting in group C, and taking 200 ml of 10% glucose solution 2 hours before surgery. Through comparison and analysis, this paper explores the influence of drinking prohibition before cesarean section on the safety and comfort of parturients. Result: The satisfaction and comfort of group C was significantly higher than that of the other two groups, and the difference was statistically significant (p < 0.05). Conclusion: The influence of oral carbohydrate 2 hours before cesarean section on the blood sugar of the parturient, the aspiration of the parturient, the comfort of the parturient, and the health of the fetus has very obvious effects.
Keywords:Drinking Prohibition, Cesarean Section, Security, Comfort
Copyright © 2022 by author(s) and Hans Publishers Inc.
This work is licensed under the Creative Commons Attribution International License (CC BY 4.0).
http://creativecommons.org/licenses/by/4.0/
剖宫产是产科当中比较重要的手术,有助于解决难产以及相关并发症,是挽救产妇与围产儿生命的重要方法 [
截取2020年9月至2022年3月来我院接受择期手术的剖宫产产妇作为研究对象,抽取90例,产妇均经随机数字表法进行分组,分别为A组、B组与C组,各30例。三组患者年龄区间均为20岁到34岁,其中A组患者的平均年龄为27.21 ± 1.36岁;B组患者的平均年龄为27.35 ± 1.15岁;C组患者的平均年龄为27.27 ± 1.45岁。三组患者的一般资料对比差异不显著(p > 0.05)。与此同时,90例患者都签署了知情同意书,并获得院伦理委员会的批准,两组数据之间无统计学意义(p < 0.05),具体如下表1所示:
组别 | 产妇 | 平均年龄 | 年龄界限 |
---|---|---|---|
A组 | 30 | 27.21 ± 1.36 | 20~34 |
B组 | 30 | 27.35 ± 1.15 | 20~34 |
C组 | 30 | 27.27 ± 1.45 | 20~34 |
表1. 剖宫产术前禁饮禁食产妇患者数据记录表
A组患者在剖宫产手术开始之前严格按照教科书中内容禁饮禁食,即禁饮4小时,禁食8小时;B组患者在剖宫产手术开始之前严格按照教科书中内容禁食8小时,术前2小时予以患者200 ml清水口服;C组患者在剖宫产手术开始之前严格按照教科书中内容禁食8小时,术前2小时予以200 ml 10%葡萄糖溶液予以口服,其中每100 ml饮品包含14.1 g碳水化合物。
比较三组产妇进入手术室口渴、饥饿、焦虑情况,出入手术室时血糖情况。口渴、饥饿、焦虑评分:采用VAS评分表作为评分标准,分数越高,情况越糟糕;由麻醉师观察产妇术中是否存在反流误吸情况。
采用spss22.0统计学软件进行统计分析,计量数据以( X ¯ ± S )表示,采用t来进行检验,计数数据采用百分比(%)表示,采用卡方检验,p < 0.05表示差异具有统计学意义。
在给予剖宫产手术的基础上,最后所有的产妇和新生儿都顺利出院,在对数据进行统计分析以后,得到了3个组的舒适度、血糖情况、口渴、饥饿、焦虑程度、满意度评分平均值。
C组产妇的饥饿、焦虑评分相比于B组、A组低,p < 0.05;C组、B组之间的口渴评分差异不大,p > 0.05;C组、B组的口渴评分比A组低,p < 0.05;B组、A组的饥饿、焦虑评分差异无意义,p > 0.05,数据见表2。
组别 | 例数 | 饥饿 | 口渴 | 焦虑 |
---|---|---|---|---|
A组 | 30 | 6.51 ± 1.52* | 6.72 ± 1.45* | 6.99 ± 1.24* |
B组 | 30 | 6.59 ± 1.58*# | 4.29 ± 1.21& | 6.89 ± 1.42*# |
C组 | 30 | 4.33 ± 1.31 | 4.64 ± 1.36 | 5.11 ± 1.25 |
表2. 三组产妇进入手术室状态评分对比( X ¯ ± S ,分)
*:与C组相比有统计学意义;#:与A组相比无统计学意义;&:与C足相比无统计学意义。
进入手术室时,三组产妇血糖水平差异不显,p < 0.05;出手术室时,C组产妇血糖水平比B组、A组高,p < 0.05,见表3。
C组产妇术中并未发生反流、误吸等情况,B组产妇中有6例产妇出现反流情况,发生率为20% (6/30),C组产妇有7例产妇发生误吸、反流情况,发生率为23.33% (7/30),相比于C组发生率明显较高(p < 0.05)。
组别 | 例数 | 进入手术室时 | 出手术室时 |
---|---|---|---|
A组 | 30 | 4.15 ± 0.35* | 3.92 ± 0.25* |
B组 | 30 | 4.12 ± 0.44*# | 4.01 ± 0.31*# |
C组 | 30 | 5.46 ± 0.38 | 5.22 ± 0.35 |
表3. 三组产妇出入手术室时血糖水平比较( X ¯ ± S , mmol/L)
*:与C组相比有统计学意义;#:与A组相比无统计学意义。
对于剖宫产产妇来说,术前长时间禁食禁水旨在预防术中反流、误吸等情况,这一方式对产妇的影响比较大,可能会导致产妇发生低血糖,影响产妇及新生儿的安全 [
在相关数据的统计中,我国每年有70多万的剖宫产产妇患者,所以对于剖宫产产妇来说,及时有效的治疗,对剖宫产术前禁饮禁食的事情是十分有必要的 [
同时从结果上看:C组产妇术后血糖、新生儿血糖相比于B组、C组更高,p < 0.05;C组产妇术中也并未发生反流、误吸等情况。说明术前2小时口服碳水化合物有助于改善产妇血糖水平及避免产妇出现误吸、倒流等情况的发生。
综上所述,在剖宫产术后产妇的治疗过程中,利用术前2小时口服碳水化合物是非常有必要的,提高产妇的舒适度和满意度,有助于改善产妇血糖水平,可以避免产妇出现误吸、倒流等情况的发生,对剖宫产术后产妇的治疗效果非常显著,应在产科的临床护理中加以推广。但目前仍然缺乏足够的大样本医学证据支持术前2小时口服碳水化合物在产科领域的运用效果,特别是针对患有妊娠期糖尿病、糖尿病合并妊娠等高危孕产妇,尚有待于进一步的临床研究及探讨,为术前2小时口服碳水化合物应用于择期剖宫产的最佳方案提供科学的依据。
义乌市科研项目20-3-193。
黄黎霞,张晓青,黄江萍. 剖宫产术前不同禁饮方式对产妇安全性及舒适度的影响Effect of Different Drinking Prohibition Methods on the Safety and Comfort of Parturients before Cesarean Section[J]. 临床医学进展, 2022, 12(10): 9412-9416. https://doi.org/10.12677/ACM.2022.12101361