局解手术学杂志2025，Vol.34Issue(11)：1004-1007,4.DOI:10.11659/jjssx.01E025030
术前口服碳水化合物对超重或肥胖患者Trendelenburg体位行腹腔镜子宫切除的影响
Effect of preoperative oral carbohydrate on overweight or obese patients undergoing laparoscopic hysterectomy in Trendelenburg position
摘要
Abstract
Objective To clarify the effect of preoperative oral carbohydrate on overweight or obese patients undergoing laparoscopic hysterectomy in Trendelenburg position.Methods A total of 72 overweight or obese patients who underwent laparoscopic hysterectomy in Trendelenburg position at Yancheng Third People's Hospital from September 2022 to August 2024 were selected,and randomly divided into the control group and the observation group,with 36 cases in each group.The control group received routine restriction of fasting and fluid starting from 22:00 on the day before surgery,while the observation group was given an additional 300 mL of carbohydrate orally 2 hours before anesthesia on the basis of the control group.The preoperative ultrasound results of gastric antrum,Perlas classification,full stomach status,visual analogue scale(VAS)scores for thirst and hunger,awakening time,tracheal extubation time,intraoperative hypothermia,gastro-intestinal function recovery time,and adverse reactions were compared between the two groups.Results Before anesthesia,there was no statistically significant difference in the cross-sectional area of the gastric antrum(CSA)in the right lateral position,gastric volume(GV),or the ratio of gastric volume to body weight(GV/W)between the two groups(P>0.05).There was also no statistically significant difference in the Perlas classification of gastric antrum ultrasound or the incidence of full stomach between the two groups(P>0.05).Immediately before anesthesia,the VAS scores for thirst and hunger in the observation group were significantly lower than those in the control group(P<0.05).The awakening time,tracheal extubation time,and incidence of intraoperative hypothermia in the observation group were significantly shorter/lower than those in the control group(P<0.05).The observation group had significantly shorter time of first exhaust and defecation after surgery,as well as lower incidence of postoperative bloating,compared with the control group(P<0.05).Conclusion For overweight or obese patients undergoing laparoscopic hysterectomy in the Trendelenburg position,oral intake of 300 mL carbohydrate 2 hours before anesthesia does not increase the risk of regurgitation or aspiration,with safety and reliability.It not only can improve comfort of patients and promote post-anesthesia awakening,but also can reduce the incidences of intraoperative hypothermia and gastrointestinal adverse reactions,which is conducive to accelerating postoperative recovery.关键词
碳水化合物/Trendelenburg体位/腹腔镜/子宫切除/超重/肥胖Key words
carbohydrates/Trendelenburg position/laparoscopy/hysterectomy/overweight/obesity分类
临床医学引用本文复制引用
韦广乐,陆容祥,仇晶辉,陈昌,戴体俊..术前口服碳水化合物对超重或肥胖患者Trendelenburg体位行腹腔镜子宫切除的影响[J].局解手术学杂志,2025,34(11):1004-1007,4.基金项目
盐城市科技指导计划(Z2023032) （Z2023032）
