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目的 探讨优化禁食禁饮流程对晚间接台的机器人辅助前列腺癌根治术患者快速康复的影响.方法 选取浙江大学医学院附属邵逸夫医院泌尿外科2018年6月至2019年3月晚间接台的机器人辅助前列腺癌根治术患者40例,依据数字表法随机分为两组.对照组17例采用常规术前1d 24:00开始禁食禁饮方案,研究组23例采用术前禁食禁饮优化流程.记录比较两组患者术前禁食禁饮时间、术前静脉补液量、术前术后饥饿感和口渴感评分、围手术期血糖、术后住院时间等各项指标.饥饿感及口渴感采用李克特评分法.结果 研究组和对照组术前禁食时间分别为(11.9±4.4)h和(19.3±4.8)h,术前禁饮时间分别为(6.0±2.9)h和(19.3±4.8)h,术前静脉输液量分别为(406.5±310.5)ml和(744.1±443.0)ml,差异均有统计学意义(P<0.01).研究组的术前术后饥饿感和口渴感评分均低于对照组,术后住院时间短于对照组(P<0.05).结论 对于晚间接台的机器人辅助前列腺癌根治术患者,优化术前禁食禁饮流程可以缩短术前禁食禁饮时间,减少术前输液量,缓解围手术期饥饿感、口渴感等不适,促进患者术后康复.

Objective To investigate the effect of optimized preoperative dietary management on enhanced recovery in patient with consecutive operation of robot-assisted radical prostatectomy(RARP) at night. Methods Forty patients undergoing consecutive operation of robot-assisted radical prostatectomy at night in the department of urology in our hospital from Jun 2018 to March 2019 were divided into two groups, 23 patients in the study group and 17 patients in the control group. The control group followed the traditional fasting program at 24:00 p. m. the day before the surgery. In the study group, the preoperative fasting procedure was optimized. The fasting time, water deprivation time, intravenous infusion volume, scores of hunger and thirst, blood glucose level, length of postoperative hospital stay and adverse reactions were compared between two groups. The level of hunger and thirst were evaluated using the Likert score. Results The preoperative fasting time and water deprivation time of the study group and the control group were (11.9 ± 4.4 vs 19.3 ± 4.8) h and (6.0 ± 2.9 vs 19.3 ± 4.8) h, respectively (P<0.01). The infusion volume of study group was (406.5±310.5) ml and that of control group (744.1±443.0) ml, the difference was statistically significant (P<0.01). The hunger and thirst scores of the study group were lower than those of the control group before surgery, and the postoperative hospital stay was shorter than the control group (P<0.05). Conclusion The optimized preoperative dietary management shortens fasting and water deprivation time, reduces the intravenous infusion volume, relieves the hungry and thirsty in patients with consecutive operation of robot-assisted radical prostatectomy at night.