颅脑创伤全身麻醉手术患者采用超声测量胃横截面计算液量对预防麻醉诱导期返流误吸的价值  

The value of measuring gastric cross-section by ultrasound and calculating fluid volume in preventing reflux and aspiration during anesthesia inductionin patients with craniocerebral trauma undergoing general anesthesia

作　　者：袁必航 邓玉辉 黄金平 YUAN Bi-hang(Medical community office,Nanhai hospital of Southern Medical University,Foshan,Guangdong,528244,China)

机构地区：[1]南方医科大学南海医院医共体办公室,广东佛山528244 [2]南方医科大学南海医院麻醉科,广东佛山528244

出　　处：《齐齐哈尔医学院学报》2021年第4期306-308,共3页Journal of Qiqihar Medical University

摘　　要：目的分析超声测量胃横截面计算胃液量对于预防颅脑创伤全身麻醉手术患者麻醉诱导期返流误吸的价值。方法选择2018年1月—2020年1月在本院接受全身麻醉手术的212例颅脑创伤患者作为研究对象。97例颅脑创伤患者均以超声测量胃横截面计算胃液量,抽取胃液并送检。再抽取同期入院行全身麻醉手术的115例颅脑创伤患者,计算出胃液量后,根据胃液量分为A组(胃液量≤0.4 ml/kg, 22例)、B组(0.5~0.8 ml/kg, 36例)和C组(胃液量>0.8 ml/kg, 57例)三组。对比97例患者的超声测量与实际抽取的胃液量、不同抽取时间的胃液量与胃窦部横截面积及115例中三组患者的返流误吸发生情况。结果 97例颅脑创伤患者经超声测量后,其胃窦部横截面积为(449.96±190.33)mm^(2),超声测量胃液量与实际抽取胃液量比较,差异无统计学意义(P>0.05);空腹状态下患者胃窦部横截面积及胃液量最低;于饱腹状态时患者胃窦部横截面积及胃液量最高,随着进食时间不断延长,胃窦部横截面积及胃液量逐渐降低。空腹状态下患者的胃窦部横截面积及胃液量低于饱腹状态时,差异具有统计学意义(P<0.05);C组患者的返流误吸发生率(38.60%)高于A组(4.55%)及B组(13.89%),差异具有统计学意义(P<0.05)。结论超声测量胃横截面计算胃液量对于预防颅脑创伤全身麻醉手术患者麻醉诱导期返流误吸具有重要意义,可将>0.8 ml/kg视作反流呼吸危险性评估的重要标准。Objective To analyze the value of ultrasound measurement of gastric cross-section and calculation of gastric juice volume in preventing reflux and aspiration during anesthesia induction in patients with craniocerebral traumaundergoing general anesthesia.Methods Totally 212 cases of patients with craniocerebral trauma those received surgery underwent general anesthesia in our hospital from January 2018 to January 2020 were enrolled as study subjects.Take ultrasound to measure the cross-section of the stomach and calculate the amount of gastric juice in 97 cases of craniocerebral trauma patients,and then gastric juice was drawn and sent for examination.For the other 115 patients with craniocerebral trauma who were admitted to the hospital for general anesthesia during the same period.After calculating the amount of gastric juice,they were grouped according to the amount of gastric juice,22 cases with gastric juice volume≤0.4 ml/kg were considered as group A,36 cases with 0.5ml/kg~0.8ml/kg as group B,and 57 cases with>0.8 ml/kg as group C.The volume of gastric juice measured by ultrasound and the actual volume of gastric juice,the volume of gastric juice at different extraction timesand the cross-sectional area of gastric antrum,and the occurrence of reflux and aspiration were compared between the three groups.Results The cross-sectional area of gastric antrum of 97 patients was(449.96±190.33)mm^(2),and the amount of gastric juice measured by ultrasound was similar to the actual sampled amount,the difference was not statistically significant(P>0.05).In the fasting state,the cross-sectional area of the gastric antrum and the amount of gastric juice were the lowest in the patient,and the highest in the full state,and gradually decreases with the continuous extension of eating time.The cross-sectional area of the gastric antrum and the amount of gastric juice at the fasting state were significant lower than those at full state(P<0.05).The incidence of reflux aspiration in group C was 38.60%,which was higher than 4.5

关 键 词：超声 胃横截面 胃液量 颅脑创伤 全身麻醉手术 返流误吸 

分 类 号：R614[医药卫生—麻醉学]