术前口服碳水化合物电解质液对无痛结肠镜检查患者舒适度和胃容量的影响

Impact of oral carbohydrate electrolyte solution on the comfort and gastric volume of patients who accepted painless colonoscopy

摘要:

目的 观察术前口服碳水化合物电解质液对无痛结肠镜检查患者舒适度和胃容量的影响。方法 选择2024年7月－2024年12月该院拟行择期无痛结肠镜检查的患者120例，采用随机数表法将患者分为观察组（口服碳水化合物电解质液组）和对照组，各60例。记录检查相关情况［胃窦横截面积（CSA）、胃容量、下腔静脉塌陷指数（IVC-CI）和结肠镜检查时间］。记录检查开始时（T₁）、检查结束时（T₂）和离院时（T₃）的平均动脉压（MAP）、心率（HR）和经皮动脉血氧饱和度（SpO₂）。记录所有患者检查前2 h（T₀）、T₁和T₃时点的口渴及饥饿视觉模拟评分法（VAS）评分、腹胀程度（李克特评分）和焦虑自评量表（SAS）评分。记录苏醒时间、麻醉复苏室（PACU）停留时间、离院时Christensen疲劳评分和满意度评分。记录血管活性药物使用情况和液体输注量。观察低血压、心动过缓和胃肠道症状等不良事件发生情况。结果 T₁时点，两组患者CSA和胃容量比较，差异均无统计学意义（P > 0.05）；观察组IVC-CI明显低于对照组，差异有统计学意义（P < 0.05）。两组患者结肠镜检查时间比较，差异无统计学意义（P > 0.05）。两组患者T₁时点MAP和HR比较，T₁、T₂和T₃时点SpO₂比较，差异均无统计学意义（P > 0.05）；观察组T₂和T₃时点MAP和HR明显高于对照组，差异均有统计学意义（P < 0.05）。与T₀时点比较，对照组T₁和T₃时点的口渴及饥饿VAS评分、SAS评分和李克特评分明显升高；观察组T₁和T₃时点的口渴及饥饿VAS评分和SAS评分明显降低，李克特评分明显升高，差异均有统计学意义（P < 0.05）。观察组T₁和T₃时点的口渴及饥饿VAS评分、SAS评分和李克特评分明显低于对照组，差异均有统计学意义（P < 0.05）。观察组去氧肾上腺素和阿托品使用量明显少于对照组，PACU停留时间明显短于对照组，离院时Christensen疲劳评分明显低于对照组，患者满意度评分明显高于对照组，差异均有统计学意义（P < 0.05）；两组患者液体输注量和麻醉苏醒时间比较，差异均无统计学意义（P > 0.05）。观察组低血压、心动过缓、恶心呕吐和腹痛发生率明显低于对照组，差异均有统计学意义（P < 0.05）。结论 结肠镜检查患者在检查前2 h口服碳水化合物电解质液，可明显减轻围手术期口渴、饥饿和腹胀程度，缓解焦虑，提高患者满意度，患者血流动力学稳定，术后恢复时间短，可缓解术后疲劳。值得临床推广应用。

Abstract:

Objective To observe the influence of preoperative oral administration of carbohydrate electrolyte solution on the comfort and gastric volume of patients undergoing painless colonoscopy.Methods A total of 120 patients who were scheduled to undergo elective painless colonoscopy from July 2024 to December 2024 were selected and the patients were divided into the observation group (oral carbohydrate electrolyte solution group) and the control group by the random number table method, 60 cases each. Record the relevant conditions of the examination [cross sectional area (CSA), gastric volume, inferior vena cava collapse index (IVC-CI) and colonoscopy time]. Record the mean arterial pressure (MAP), heart rate (HR), and percutaneous arterial oxygen saturation (SpO₂) at the beginning of the examination (T₁), the end of the examination (T₂), and the time of discharge (T₃). The visual analogue scale (VAS) scores for thirst and hunger, the degree of abdominal bloating (Likert score), and the self-rating anxiety scale (SAS) of all patients were recorded at 2 hours before the examination (T₀), T₁, and T₃ time points. Record the recovery time, the duration of stay in the postanesthesia care unit (PACU), the Christensen fatigue score at the time of discharge and the satisfaction score. Record the usage of vasoactive drugs and the volume of fluid infusion. Observe the occurrence of adverse events such as hypotension, bradycardia and gastrointestinal symptoms.Results At time point T₁, there was no statistically significant difference in CSA and gastric volume between the two groups of patients (P > 0.05). The IVC-CI in the observation group was significantly lower than that in the control group, and the difference was statistically significant (P < 0.05). There was no statistically significant difference in the colonoscopy examination time between the two groups of patients (P > 0.05). There was no statistically significant difference in MAP and HR between the two groups of patients at time point T₁, and in SpO₂ at time points T₁, T₂ and T₃ (P > 0.05). The MAP and HR of the observation group at time points T₂ and T₃ were significantly higher than those of the control group, and the differences were statistically significant (P < 0.05). Compared with time point T₀, the VAS score for thirst and hunger, SAS score and Likert score of the control group at time points T₁ and T₃ were significantly increased. The VAS scores for thirst and hunger, as well as the SAS scores at time points T₁ and T₃ in the observation group, were significantly decreased, while the Likert score was significantly increased. The differences were statistically significant (P < 0.05). The VAS scores for thirst and hunger, SAS scores and Likert scores of the observation group at time points T₁ and T₃ were significantly lower than those of the control group, and the differences were statistically significant (P < 0.05). The usage of deoxyepinephrine and atropine in the observation group was significantly less than that in the control group, the PACU stay time was significantly shorter than that in the control group, the Christensen fatigue score at discharge was significantly lower than that in the control group, and the patient satisfaction score was significantly higher than that in the control group. The differences were all statistically significant (P < 0.05). There was no statistically significant difference in the fluid infusion volume and anesthesia recovery time between the two groups of patients (P > 0.05). The incidences of hypotension, bradycardia, nausea and vomiting, and abdominal pain in the observation group were significantly lower than those in the control group, and the differences were statistically significant (P < 0.05).Conclusion The first 2 h before the examination of oral carbohydrate electrolyte fluid is taken, which can obviously reduce the degree of thirst, hunger and abdominal bloating in the perioperative period, relieve anxiety, improve patient satification. And the patient's blood flow dynamic is stable, the postoperative recovery time is short, it can relieve postoperative fatigue, optimize the patient experience. It deserves clinical promotion.