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不同麻醉方法下剖宫产术后早期与延迟经口喂养——一项关于剖宫产麻醉与喂养的随机对照试验

Early versus delayed oral feeding after cesarean delivery under different anesthetic methods--a randomized controlled trial anesthesia, feeding in cesarean delivery.

作者信息

Aydin Yunus, Altunyurt Sabahattin, Oge Tufan, Sahin Fezan

出版信息

Ginekol Pol. 2014 Nov;85(11):815-22. doi: 10.17772/gp/1906.

Abstract

OBJECTIVE

The aim of the study was to evaluate the safety and efficacy of early feeding after cesarean delivery under different anesthetic methods.

STUDY DESIGN

Two hundred women with elective cesarean delivery were randomly assigned to early oral feeding (EOF) or routine oral feeding (ROF) groups. EOF patients were informed that they could begin taking fluids orally (regime I) as soon as 2 hours after the delivery and then gradually progress to solid foods (regime III), if tolerated. ROF patients were informed that they could start regime I right after bowel sounds were heard on examination and then gradually move on to regime III. Hospitalization time and total time to ambulation (primary outcomes), gasstool discharge time and onset of bowel sounds (secondary outcomes) were compared in groups A [EOF patients after regional anesthesia (n=49)}, B [EOF patients after general anesthesia (n=48)}, C [ROF patients after regional anesthesia (n=47)} and 0 [ROF patients after general anesthesia (n=48)].

RESULTS

There were significant differences in primary and secondary outcomes between group A and the remaining groups, especially group D. The status of patients from group B was not better than group C. In fact, the latter were discharged home sooner and passage of gas, as well as initiation of regime I occurred earlier as compared to the former

CONCLUSIONS

Cesarean section under regional anesthesia and encouragement of oral feeding 2 hours after the operation should be recommended in order to acnieve postoperative recovery and early hospital discharge. Routine oral feeding (right after bowel sounds are heard on examination) after cesarean section under general anesthesia should be the last choice.

摘要

目的

本研究旨在评估不同麻醉方法下剖宫产术后早期喂养的安全性和有效性。

研究设计

200例行择期剖宫产的女性被随机分为早期口服喂养(EOF)组或常规口服喂养(ROF)组。EOF组患者被告知,产后2小时即可开始口服液体(方案I),若耐受,随后可逐渐过渡到固体食物(方案III)。ROF组患者被告知,检查时听到肠鸣音后即可开始方案I,然后逐渐过渡到方案III。比较A组[区域麻醉后EOF患者(n = 49)]、B组[全身麻醉后EOF患者(n = 48)]、C组[区域麻醉后ROF患者(n = 47)]和D组[全身麻醉后ROF患者(n = 48)]的住院时间和完全下床活动总时间(主要结局)、排气排便时间和肠鸣音出现时间(次要结局)。

结果

A组与其余各组(尤其是D组)在主要和次要结局方面存在显著差异。B组患者的情况并不优于C组。事实上,与前者相比,后者出院更早,排气以及开始方案I的时间也更早。

结论

建议采用区域麻醉下剖宫产并在术后2小时鼓励口服喂养,以促进术后恢复并早日出院。全身麻醉下剖宫产术后常规口服喂养(检查时听到肠鸣音后立即开始)应作为最后选择。

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