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來源文獻資料
摘要
外文摘要
引文資料
題名:
術前進食液體利弊之系統性文獻探討暨統合分析
書刊名:
護理雜誌
作者:
林芳子
/
林采蓉
/
廖佳偉
/
陳淑惠
作者(外文):
Lin, Fang-tzu
/
Lin, Tsai-rung
/
Liao, Chia-wei
/
Chen, Shu-hui
出版日期:
2017
卷期:
64:4
頁次:
頁79-88
主題關鍵詞:
手術病人
;
術前禁食
;
胃殘餘量
;
胃液酸鹼值
;
自覺感受
;
Surgical patients
;
Preoperative fasting
;
Gastric fluid volume
;
Gastric fluid PH
;
Self-perception
原始連結:
連回原系統網址
相關次數:
被引用次數:期刊(0) 博士論文(0) 專書(0) 專書論文(0)
排除自我引用:0
共同引用:0
點閱:8
背景:術前長時間禁食,可能會增加手術期間血液動力學不穩定,甚至影響術後電解質平衡。目前國內缺乏探討禁食時間、進食的液體量對於胃液酸鹼值、胃殘餘量、手術中吸入性肺併發症及病人自覺感受之系統性文獻回顧。目的:以系統性文獻回顧及統合分析,探討術前進食液體之利弊。方法:以中英文關鍵字及設定條件,搜尋NRC(Nursing Reference Center)、CINAHL(Cumulative Indexto Nursing and Allied Health Literature)、WOS(Web of Science)、PubMed、The Cochrane Library、UpToDate、DynaMed、NGC(National Guideline Clearinghouse)、華藝線上圖書館及臺灣碩博士論文知識加值系統,共十個資料庫,時間設定2003年至2017年1月,共獲得30篇文獻,排除不符合條件之文獻後共9篇納入分析。依據「牛津大學實證醫學證據等級表2011版」來進行證據等級評定,文章品質則運用CASP(Critical Appraisal Skills Program)作為評讀工具,以RevMan 5.1版進行統合分析。結果:文獻品質介於中等至高等,術前2小時進食少量至中量的液體,並未顯著增加病人麻醉期間的胃殘餘量,其效果量為2.37(95% CI [-5.12, 9.85], p = .54);亦未影響胃液酸鹼值,效果量為0.10(95% CI[0.00, 0.20], p = .05)。結論:結果顯示,術前2小時進食少量至中量液體,並未顯著增加病人麻醉期間之胃殘餘量及胃液酸鹼值,此外其益處可降低手術中吸入性肺炎、胃食道逆流及併發症發生的風險,更能減緩術前口渴與飢餓感受,此分析進而支持手術前進食少量至中量液體,顯示其優點多於弊。
以文找文
Background: Preoperative anesthesia long time fasting, may increase patient hemodynamic instability during surgery and may affect the patient’s post-surgery electrolyte balance. No meta-analysis has been conducted to explore the effects of preoperative liquid intake amount on gastric fluid PH, gastric fluid volume, surgery inhalation of pulmonary complications, and patient self-perceptions quality of care systematic review and meta-analysis of the literature. Purpose: To assess the pros and cons of preoperative liquid intake using a systematic review of the literature. Methods: The authors searched ten databases including NRC (Nursing Reference Center), CINAHL (Cumulative Index to Nursing and Allied Health Literature), WOS (Web of Science), PubMed, The Cochrane Library, UpToDate, DynaMed, NGC (National Guideline Clearinghouse), Airiti Library, and National Digital Library of Theses and Dissertations in Taiwan, to identify relevant articles that were published from 2003 to January 2017. Nine qualified articles were included in the analysis from the 30 articles that were selected using an initial keyword search. The Oxford Centre for Evidence-based Medicine 2011 Levels of Evidence was used as the evidence grade and the CASP (Critical Appraisal Skills Program) was used to evaluate the quality of the selected articles. The quantitative results were analyzed using Review Manager, Version 5.1. Results: The quality of the literature was medium to high. A small to moderate dose of fluid consumed at 2 hours prior to surgery did not significantly increase gastric fluid volume during anesthesia, with a combined effect of 2.37 (95% CI [-5.12, 9.85], p = .54), and had no effect on gastric fluid PH, with a combined effect of 0.10 (95% CI [0.00, 0.20], p = .05). Conclusions / Implications for Practice: The results indicate that consuming a small to moderate dose of liquid at 2 hours prior to the provision of anesthesia does not significantly increase the gastric fluid volume or gastric fluid PH of patients during anesthesia. Moreover, the positive benefits of consuming this dose of liquid include reduced risks of aspiration pneumonia, gastroesophageal reflux disease, and postoperative complications as well as reduced perceptions of thirst and hunger during the immediate preoperative period. Thus, this analysis supports that the advantages of allowing patients to consume a moderate or smaller dose of liquid prior to surgery outweigh the disadvantages.
以文找文
期刊論文
1.
林廷燦、朱文洋、劉怡君、鍾瑞嶂(20121200)。外科病人手術前後心血管風險評估及內科處理。內科學誌,23(6),403-421。
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2.
American Society of Anesthesiologists Committee on Standards and Practice Parameters(2011)。Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: Application to healthy patients undergoing elective procedures: An updated report by the American Society ofAnesthesiologists。Anesthesiology,114(3),495-511。
3.
American Society of Anesthesiologists Task Force(2017)。Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: Application to healthy patients undergoing elective procedures。Anesthesiology,126(3),376-393。
4.
American Society of Anesthesiologists Task Force on Preoperative Fasting(1999)。Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: Application to healthy patients undergoing elective procedures: A report by the American Society of Anesthesiologist Task For。Anesthesiology,90(3),896-905。
5.
Bopp, C.、Hofer, S.、Klein, A.、Weigand, M. A.、Martin, E.、Gust, R.(2009)。A liberal preoperative fasting regimen improves patient comfort and satisfaction with anesthesia care in day-stay minor surgery。Minerva Anestesiologica,77(7),680-686。
6.
Borges Dock-Nascimento, D.、Aguilar-Nascimento, J. E.、Caporossi, C.、Sepulveda MagalhãesFaria, M.、Bragagnolo, R.、Caporossi, F. S.、Linetzky Waitzberg, D.(2011)。Safety of oral glutamine in the abbreviation of preoperative fasting: A double-blind, controlled, randomized clinical trial。Nutrición Hospitalaria,26(1),86-90。
7.
Brady, M. C.、Kinn, S.、Stuart, P.、Ness, V.(2003)。Preoperative fasting for adults to prevent perioperative complications。Cochrane Database of Systematic Reviews,4,CD004423。
8.
Breuer, J.-P.、von Dossow, V.、von Heymann, C.、Griesbach, M.、von Schickfus, M.、Mackh, E.、Spies, C. D.(2006)。Preoperative oral carbohydrate administration to ASA IIIIV patients undergoing elective cardiac surgery。Anesthesia & Analgesia,103(5),1099-1108。
9.
Dalal, K. S.、Rajwade, D.、Suchak, R.(2010)。"Nil per oral after midnight" : Is it necessary for clear fluids?。Indian Journal of Anaesthesia,54(5),445-447。
10.
Falconer, R.、Skouras, C.、Carter, T.、Greenway, L.、Paisley, A. M.(2014)。Preoperative fasting: Current practice and areas for improvement。Updates in Surgery,66(1),31-39。
11.
Itou, K.、Fukuyama, T.、Sasabuchi, Y.、Yasuda, H.、Suzuki, S.、Hinenoya, H.、Suzuki, T.(2012)。Safety and efficacy of oral rehydration therapy until 2h before surgery: A multicenter randomized controlled trial。Journal of Anesthesia,26(1),20-27。
12.
Maltby, J. R.、Pytka, S.、Watson, N. C.、McTaggart Cowan, R. A.、Fick, G. H.(2004)。Drinking 300 mL of clear fluid two hours before surgery has no effect on gastric fluid volume and pH in fasting and non-fasting obese patients。Canadian Journal of Anaesthesia,51(2),111-115。
13.
Mendelson, C. L.(1946)。The aspiration of stomatch contents into the lungs during obstetric anaesthesia。American Journal of Obstectrics & Gynecology,52(2),191-205。
14.
Nakai, K.、Niwa, H.、Kitayama, M.、Satoh, Y.、Hirota, K.(2012)。Effects of oral rehydration therapy on gastric volume and pH in patients with preanesthetic H2 antagonist。Journal of Anesthesia,26(6),936-938。
15.
Pimenta, G. P.、de Aguilar-Nascimento, J. E.(2014)。Prolonged preoperative fasting in elective surgical patients: Why should we reduce it?。Nutrition in Clinical Practice,29(1),22-28。
16.
Sada, F.、Krasniqi, A.、Hamza, A.、Gecaj-Gashi, A.、Bicaj, B.、Kavaja, F.(2014)。A randomized trial of preoperative oral carbo hydrates in abdominal surgery。BMC Anesthesiology,14(1),93。
17.
Singh, M.、Chaudhary, M.、Vashistha, A.、Kaur, G.(2015)。Evaluation of effects of a preoperative 2-hour fast with glutamine and carbohydrate rich drink on insulin resistance in maxillofacial surgery。Journal of Oral Biology and Craniofacial Research,5(1),34-39。
18.
Smith, L.、Kranke, P.、Murat, I.、Smith, A.、O'Sullivan, G.、Søreide, E.、Veld, B.(2011)。Perioperative fasting in adults and children: Guidelines from the European Society of Anaesthesiology。European Journal of Anaesthesiology,28(8),556-569。
19.
Yagci, G.、Can, M. F.、Ozturk, E.、Dag, B.、Ozgurtas, T.、Cosar, A.、Tufan, T.(2008)。Effects of preoperative carbohydrate loading on glucose metabolism and gastric contents in patients undergoing moderate surgery: A randomized controlled trial。Nutrition,24(3),212-216。
20.
莊其穆(20110200)。臨床醫師如何閱讀統合分析(Meta-analysis)的論文。臺灣醫界,54(2),18-26。
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