剖宫产术前胃内容物水平的临床评估:超声法测定胃窦部横截面积  

Clinical assessment of gastric contents before cesarean section: antral cross-sectional area measured using ultrasonography

作　　者：张文琪 曾祥刚 姬书青 宋涛 Zhang Wenqi;Zeng Xianggang;Ji Shuqing;Song Tao(Department of Anesthesiology, Hospital of Guizhou Medical University, Guiyang 520000, China)

机构地区：[1]贵州医科大学附属医院麻醉科,贵阳520000

出　　处：《中华麻醉学杂志》2019年第1期78-80,共3页Chinese Journal of Anesthesiology

摘　　要：目的采用超声法测定胃窦部横截面积(CSA)评估剖宫产术前胃内容物的水平。方法行剖宫产术患者177例,年龄20~44岁,ASA分级Ⅰ-Ⅲ级。麻醉开始前,分别于半卧位(头高45°)和右侧卧位时,采用超声取剑突下矢状面胃窦图像测定CSA,并进行定性分级。以定性分级0级为金标准,绘制CSA评估胃内容物水平的ROC曲线。结果半卧位CSA的ROC曲线临界值为6.025 cm^2。右侧卧位CSA的ROC曲线临界值为:9.095 cm^2。结论半卧位时超声测量的CSA<6.025 cm^2或右侧卧位时超声测量的CSA<9.095 cm^2,可判断剖宫产术前达到了胃排空状态。Objective To assess the gastric contents before cesarean section using antral cross-sectional area(CSA)measured by ultrasonography. Methods One hundred and seventy-seven American Society of Anesthesiologists physical status I-III patients, aged 20-44 yr, undergoing cesarean section, were enrolled in this study.The antral CSA in the semi-recumbent and right lateral decubitus positions was measured through the ultrasound images of the antrum in the sagittal plane below xiphoid before anesthesia and qualitatively graded.Qualitative grade 0 was considered as the gold standard, and the receiver operating characteristic(ROC)curve of CSA in assessing the preoperative gastric contents was plotted. Results The critical value of ROC curve of CSA in the semi-recumbent position was 6.025 cm^2.The critical value of ROC curve of CSA in the right lateral decubitus position was 9.095 cm2. Conclusion CSA<6.025 cm^2 measured by ultrasonography in the semi-recumbent position or CSA<9.095 cm^2 measured by ultrasonography in the right lateral decubitus position can confirm that the gastric emptying state is achieved before cesarean section.

关 键 词：剖宫产术 胃肠内容物 超声检查 胃窦部横截面积 

分 类 号：R614[医药卫生—麻醉学] R719.8[医药卫生—外科学]