Application Of Multi-disciplinary Team Model Of Preoperative Oral Carbohydrate Docking Station For Laparoscopic Cholecystectomy In Patients With Thirst And Hunger

Objective:In this study,the multidisciplinary oral carbohydrate model was applied to patients undergoing laparoscopic cholecystectomy.The safety of preoperative oral carbohydrate in receiving operation,the effect on blood glucose,and the the occurrence of perioperative thirst,hunger and complications were observed,so as to provide reference for preoperative diet nursing for patients receiving laparoscopic cholecystectomy.Methods: This study is a randomized controlled trial.Using the method of convenient sampling,76 patients undergoing laparoscopic cholecystectomy who met the inclusion and exclusion criteria in the Department of General surgery of a third-class hospital in Inner Mongolia from January 2019 to November 2019 were randomly divided into intervention group(n = 38)and control group(n = 38).The control group was treated according to the traditional preoperative diet nursing plan,that is,fasting after 12:00 before operation,and the intervention group was given oral carbohydrate regimen with multidisciplinary cooperation before operation.The degree of thirst and hunger,VAS score,blood glucose value and the incidence of aspiration pneumonia were compared and analyzed between the two groups at the time of oral carbohydrate administration on the morning of operation(T0),the first about 10 minutes of receiving patients in the operating room(T1)and the postoperative Steward awakening score of 6 points(T2).The software SPSS23.0,is used to analyze the data.The measurement data that accord with the normal distribution are expressed by (?) ±s,those that do not conform tothe normal distribution are expressed by the median(quartile interval),and the counting data are expressed by frequency or percentage(%).The measurement data in the baseline data were tested by independent sample t-test(in accordance with normal distribution)or Mann-Whitney U test(not in accordance with normal distribution),and the counting data were used in Chi-2 test.Single factor repeated measurement analysis of variance was used to compare different time points in the intervention group and control group,and two-factor repeated measurement analysis of variance was used in the comparison between the two groups at different time points.Results: 1.There was no significant difference in baseline balance between the intervention group and the control group(P > 0.05).2.Fasting and drinking time before surgery: there was no statistically significant difference in fasting time before surgery between the two groups(P > 0.05),and there was a statistically significant difference in fasting time(P <0.05).3.Thirst: comparing the two groups,the difference between T0 and T1 before oral carbohydrate group was statistically significant(P <0.05),and the difference between T1 and T2 was statistically significant(P <0.05);the difference between control group T0 and T1 Statistical significance(P <0.05),and the difference between T1 and T2 was also statistically significant(P <0.05).The comparison between the two groups was not statistically significant at T0(P> 0.05),the difference was significant at T1(P <0.05),and the difference was also statistically significant at T2(P <0.05).4.Hunger: comparing the two groups,the difference between T0 and T1 before oral carbohydrate group was statistically significant(P <0.05),and the difference between T1 and T2 was statistically significant(P <0.05);the difference between control group T0 and T1 Statistical significance(P <0.05),and the difference between T1 and T2 was also statistically significant(P <0.05).The comparison between the two groups was not statistically significant at T0(P> 0.05),thedifference was significant at T1(P <0.05),and the difference was also statistically significant at T2(P <0.05).5.Blood glucose: there was no significant difference in preoperative oral carbohydrate group between T0 and T1(P > 0.05),and there was no significant difference between T1 and T2(P > 0.05).There was no significant difference between T0 and T1 in the control group(P > 0.05),but there was significant difference between T1 and T2(P < 0.05).There was no significant difference between the two groups at T0(P > 0.05),but there was significant difference at T1(P < 0.05),and there was no significant difference at T2(P > 0.05).6.Postoperative complications: There was no significant difference in the incidence of postoperative complications between the two groups of patients(P>0.05).Conclusions: Oral carbohydrate before operation in multidisciplinary team mode(MDT)can significantly reduce the thirst and hunger of patients undergoing laparoscopic cholecystectomy caused by waiting for surgery for a long time before and after operation,and have no effect on blood sugar after operation.at the same time,it will not increase the occurrence of aspiration pneumonia and other complications,making patients more comfortable and safe during the perioperative period.At the same time,the application of MDT mode in receiving surgery can obtain relatively accurate operation time,which is convenient for clinical doctors and nurses to carry out individualized preoperative diet education for patients undergoing receiving surgery.