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手术前禁食:可以吃什么和喝什么,以及原因

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为什么在麻醉前必须禁食,即使可以少量饮水,以及如果不禁食会发生什么。确保手术期间胃部排空、肺部安全的明确禁食规则。

Updated May 2026
手术前禁食示意图:时钟旁摆放着空盘子和玻璃杯。
麻醉前禁食:在建议的时间内禁食禁水。 Kieran Hirpara 4.0

本页面由机器翻译,尚未经临床医生审核。英文版本为权威版本。

手术当天,您的安全主要取决于两个因素:您接受的麻醉类型,以及您是否严格遵守所获得的禁食指示。

为什么要求您禁食

全身麻醉会使通常防止胃内容物反流至咽喉的肌肉松弛。如果您的胃是充盈的,在您意识丧失期间,这些物质可能会误吸入肺部,这是严重的并发症。禁食可以清空胃内容物,从而避免这种情况发生。

标准规定如下:

  • 在预定到达时间前 6 小时内禁止进食或饮用牛奶。 这包括糖果、口香糖以及加奶的茶或咖啡。
  • 在到达时间前 2 小时内允许饮用清流质: 水、红茶、黑咖啡、苹果汁、透明糖浆饮料。请小口啜饮,不要大口吞咽。
  • 在到达时间前 2 小时停止饮用所有清流质。

如果您需要在早晨服用常规的降压药或抗癫痫药,请用一小口水送服,除非您的麻醉师另有指示。降糖药物和抗凝药物则不同;请遵循您收到的具体书面建议。

我们使用的麻醉类型

大多数上肢手术采用以下三种麻醉方式之一,有时也会联合使用:

  • 全身麻醉: 您会完全入睡。麻醉医生通过您手背上的小静脉输液管为您实施麻醉,并全程监护。
  • 区域神经阻滞: 将局部麻醉药注射到颈部或腋窝的神经周围,使整个手臂麻木数小时。您可能还会接受镇静治疗以在手术中入睡,但不需要使用呼吸机。
  • 局部麻醉: 小型手术(如扳机指松解术)通常可以在局部麻醉下进行,您保持完全清醒,有时辅以轻度镇静。

您的麻醉医生将在手术当天与您讨论各种选择。具体选择取决于手术类型、您的整体健康状况以及您的个人偏好。

手术当天预期情况

您需在预定手术时间前1–2小时到达。护士将检查您的禁食情况、建立静脉输液通道,并让您签署最终同意书。麻醉医师将在您进入手术室前亲自为您进行评估。

术后您将在复苏室苏醒。如果您接受了区域神经阻滞,手臂会感觉沉重且麻木;这是正常现象,通常持续8–24小时。保护麻木的手臂: 将其保持在吊带内,避免倚靠,并注意保暖。感觉会逐渐恢复,常伴有针刺感。

恶心、嗜睡以及喉咙痛(由气管插管引起)在术后最初几小时内较为常见。请缓慢饮水、清淡饮食并充分休息。

更深入的了解

本节更深入地探讨了这些规则为何如此设定。遵循禁食指示时不需要了解这些内容,但它解释了其背后的生理学原理。

为什么空腹很重要:误吸风险

当您清醒时,食管上端的反射机制可防止胃内容物反流至咽喉和气道。全身麻醉会使这些反射机制失效。如果胃内仍有食物或液体,它们可能反流并进入肺部,这种情况称为误吸。胃内容物呈酸性,因此可导致肺部炎症并引发严重的胸部感染。禁食可使胃排空,减少可反流的内容物,这也是制定禁食规定的主要原因。

为何固体食物需禁食六小时,而清流质仅需两小时

胃排空不同物质的速度不同。固体食物和乳类饮料分解缓慢,因此需要约六小时才能排空。清流质(如水、黑茶或咖啡以及澄清果汁)在数小时内即可通过,因此术前两小时内可少量饮水。当前指南积极鼓励在术前两小时内饮用清流质,因为手术前保持充分水合状态优于长时间口渴,且不会增加误吸风险。

麻醉选项的作用机制

全身麻醉作用于大脑,使您在手术期间完全无意识且无感知。区域神经阻滞作用于更远端的神经:将局部麻醉药注射到支配手臂的神经束周围(位于颈部或腋窝),从而暂时阻断沿神经传导的信号,使手臂麻木、沉重,并在您苏醒后的数小时内保持无痛。这两种麻醉方式常联合使用,既能提供平稳的麻醉效果,又能为术后第一天提供内置的镇痛作用。

如果您有以下情况,请致电我们

  • 对手术当天早晨服用的药物不确定
  • 术前数天出现不适(感冒、发烧、肠胃炎)
  • 在禁食期间误食或误饮;请在办理入住时告知我们,不要抱有侥幸心理

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