超声评估麻醉诱导期胃胀气程度与术后恶心呕吐发生率的关系  

Ultrasound assessment on relationship between incidence of nausea and vomiting with gastric distention level during anesthetic induction period

作　　者：郭波[1] 谢冕[1] 邓田[1] 邓林[1] 

机构地区：[1]重庆市中医院麻醉科,400011

出　　处：《检验医学与临床》2017年第12期1694-1696,共3页Laboratory Medicine and Clinic

基　　金：重庆市卫生和计划生育委员会医学科研计划项目(20142068)

摘　　要：目的观察麻醉诱导期胃胀气程度(利用超声测量麻醉前后胃窦面积变化)不同的患者术后恶心呕吐的发生率,从而判定胃胀气的程度对术后恶心呕吐的影响。方法观察行择期腹腔镜胆囊摘除术的患者,以腹部超声测定麻醉诱导前及诱导后胃窦的面积,选择麻醉诱导期胃胀气程度≤10%的患者为A组(对照组,32例),胃胀气程度在>10%~30%的患者为B组(30例),胃胀气程度在>30%~50%的患者为C组(33例)。观察腹腔镜下胃形状的变化及对手术操作的影响,观察术后6、12、24、48h患者恶心呕吐的发生率。结果与A组(对照组)比较,B、C组术后6、12h恶心呕吐的发生率明显升高,差异有统计学意义(P<0.05);术后24、48h恶心呕吐发生率比较,差异无统计学意义(P>0.05)。与B组比较,C组术后6、12h恶心呕吐的发生率明显升高,差异有统计学意义(P<0.05)。术后24、48h各组恶心呕吐发生率比较,差异无统计学意义(P>0.05)。结论超声评估麻醉诱导期胃胀气程度是可行的。诱导后胃胀气程度超过诱导前的10%就会增加患者术后早期恶心呕吐的发生率,这种发生率与胃胀气程度呈正相关。胃胀气程度超过术前30%,就会对手术视野暴露、术中的操作发生明显的影响。Objective To observe the incidence of postoperative nausea and vomiting in the patient with different degrees of gastric distension during anesthetic induction period in order to judge the influence of gastric distension degree（gastric antrum area before and after anesthesia measured by ultrasound）on postoperative nausea and vomiting.Methods The patients with elective laparoscopic cholecystectomy in our hospital were observed.The gastric antrum area before and after anesthetic induction was determined by abdominal ultrasonography.The patients with gastric distention degree≤10% during anesthetic induction period served as the group A（control group,32 cases）,those with gastric distention degree〉10%-30% as the group B（30 cases）and those with gastric distention degree 〉30%-50% as the group C（33 cases）.The change of gastric shape under laparoscopic operation,its influence on surgical operation and incidence rate of nausea and vomiting at postoperative 6,12,24,48 h were observed.Results Compared with the group A（control group）,the incidence rate of nausea and vomiting at postoperative 6,12 hin the group B and C was significantly increased with statistical difference（P〈0.05）,but which at postoperative 24,48 hhad no statistical difference among 3groups（P〉0.05）.Compared with the group B,the incidence rate of nausea and vomiting at postoperative 6,12 h in the group C was significantly increased,the difference was statistically significant（P〈0.05）.The incidence rate of nausea and vomiting at postoperative 24,48 hhad no statistical difference（P〉0.05）.Conclusion It is feasible to evaluate the gastric distension degree during anesthetic induction period by ultrasound.The gastric distension degree after induction exceeding 10% of that before induction could increase the incidence rate of early postoperative nausea and vomiting,which is positively correlated with the gastric distention degree.The gastric distension degree exceeding 30% of that before operation could generate obvi

关 键 词：胃胀气 超声检查 恶心 呕吐 

分 类 号：R442.1[医药卫生—诊断学]