关键词: 择期手术, 术前, 禁食禁饮, 安全性, 可行性, Meta分析

Abstract:

Objective To explore the safety and feasibility of shortening fasting and banning time on the selective perioperative period of patients.

Methods The PubMed，Embase，Cochrane Library，CNKI，CBM and Wanfang Data were searched for the randomized controlled trials（RCTs）between Jan，1998 and Aug，2018.Data extraction and screening were performed by two researchers independently.Meta analysis was conducted using RevMan 5.3 software.

Results 29 studies comprising 3049 patients were eligible for inclusion.Meta analysis showed that there were less hunger[OR=0.17，95%CI（0.10，0.29），P＜0.05]，thirst[OR＝0.15，95%CI（0.07，0.31），P<0.05]，fatigue[OR=0.04，95%CI（0.01，0.13），P<0.05] and hypoglycemia[OR=0.15，95%CI（0.06，0.38），P＜0.05] in new plan than in traditional plan.However，no significant differences were found in preoperative and intraoperative gastric secretion.Furthermore，the new plan was better than traditional plan in postoperative serum glucose[MD=-0.56，95%CI（-0.71，-0.42），P＜0.05]，insulin[MD=-3.60，95%CI（-5.02，-2.18），P＜0.05，insulin resistance index[MD=-2.41，95%CI（-3.11，-1.72），P＜0.05].

Conclusion The new plan is safe，feasible and recommended to be applied in clinical practice.It has advantages over traditional plan as it can reduce postoperative subjective discomfort，improve the perioperative metabolism and without increase the risk of anesthesia.

Key words: selective surgery, preoperative, fasting and water deprivation, security, feasibility, Meta analysis