体重正常行妇科手术患者胃部CSA与麻醉诱导期胃充气及PONV关系探讨  

The relationship investigation between gastric CSA and gastric inflation and PONV of patients with normal weight undergoing gynecological operation

作　　者：陈燕中 刘宇权 曾志文[1] 蓝思荣[2] CHEN Yanzhong;LIU Yuquan;ZHENG Zhiwei;无(Department of Anesthesiology,Meizhou People's Hospital,Meizhou 514031,China;Department of Ultrasonography,Meizhou People's Hospital,Meizhou 514031,China)

机构地区：[1]广东省梅州市人民医院麻醉一科,梅州514031 [2]广东省梅州市人民医院超声科,梅州514031

出　　处：《江西医药》2020年第8期1001-1004,共4页Jiangxi Medical Journal

基　　金：广东省梅州市医药卫生科研课题,编号2019-B-32。

摘　　要：目的探讨体重正常行妇科手术患者胃部CSA与麻醉诱导期胃充气及PONV关系。方法回顾性选取本院2018年10月-2019年10月收治体重正常行妇科手术患者共82例临床资料,根据麻醉诱导期间胃充气试验结果分组,其中26例阴性设为A组,56例阳性设为B组,比较两组一般资料、通气3min后SpO2、PETCO2、TV、胃窦/胃底CSA及PONV发生率,描绘ROC曲线计算床旁超声引导下所测定CSA曲线下面积。结果⑴两组一般资料比较差异无显著性(P>0.05);⑵两组通气3min后SpO2和PETCO2水平差异无显著性(P>0.05);B组患者通气3min后TV水平显著高于A组(P<0.05);⑶B组通气后3min胃窦和胃底CSA水平均显著高于A组(P<0.05);两组通气后3min胃窦和胃底CSA水平均显著高于通气前(P<0.05);⑷描绘ROC曲线后分析,胃窦曲线下面积、cutoff值、敏感性及特异性分别为0.69(95%CI:0.50-0.87),3.23cm^2,93.17%,39.40%;胃底曲线下面积、cutoff值、敏感性及特异性分别为0.83(95%CI:0.54-0.99),25.19cm^2,93.81%,70.26%;⑸B组PONV发生率显著高于A组(P<0.05)。结论体重正常行妇科手术患者麻醉诱导期间床旁超声引导下胃底CSA测量水平变化情况较胃窦可更为准确反映胃充气敏感性,同时胃充气状态可增加PONV发生风险。Objective To investigate the relationship between gastric CSA and gastric inflation and PONV of patients with normal weight undergoing gynecological operation.Methods Clinical data of 82 patients with normal weight undergoing gynecological operation were retrospectively chosen in the period from October 2018 to October 2019 and according to the gastric inflation test results during anesthesia induction divided into 2 groups including A group(26 vases)with negative and B group(56 cases)with positive.The levels of SpO2,PetCO2,TV,CSA and PONV incidence were compared of 2 groups;ROC curve were drawn to calculate the area under CSA curve by ultrasonic guidance beside bed.Results⑴There was no significant difference in general data between 2 groups(P>0.05).⑵There was no significant difference in the levels of SpO2 and PETCO2 between 2 groups in 3 min after ventilation(P>0.05).The TV levels of B group were significantly higher than A group in 3 min after ventilation(P<0.05).⑶The levels of CSA in gastric antrum and fundus of B group were significantly higher than A group in 3 min after ventilation(P<0.05).The levels of CSA in gastric antrum and fundus of 2 groups in 3 min after ventilation were significantly higher than before ventilation(P<0.05).⑷The area under the curve,cutoff value,sensitivity and specificity of gastric antrum were separately 0.69(95%CI:0.50-0.87),3.23 cm^2,93.17%,39.40%;the area under the curve,cutoff value,sensitivity and specificity of gastric fundus were separately 0.83(95%CI:0.54-0.99),25.19 cm^2,93.81%,70.26%.⑸The incidence of PONV of B group were significantly higher than A group(P<0.05).Conclusion The changes levels of CSA in gastric fundus under the guidance of bedside ultrasound during anesthesia induction of patients with normal weight bu gynecological operation can more accurately reflect the sensitivity of gastric inflation compared with antrum,and the gastric inflation state can increase the PONV risk.

关 键 词：妇科手术 实时超声 CSA 麻醉诱导 胃充气 PONV 

分 类 号：R614[医药卫生—麻醉学]