胃超声结合BMI对剖宫产术前禁食水时间的研究  

The Study of Gastric Ultrasound Combined With BMI in Guiding Water Fasting Time Before Caesarean Section

作　　者：朱雨竹 李莉[1] 张锐[2] 朴雪[1] 陈升月 唐明龙 ZHU Yuzhu;LI Li;ZHANG Rui;PIAO Xue;CHEN Shengyue;TANG Minglong(Department of Anesthesiology,Changchun Maternal and Child Health Hospital/Changchun Obstetrics-Gynecology Hospital,Changchun Jilin 130000,China;Department of Ultrasound,Changchun Maternal and Child Health Hospital/Changchun Obstetrics-Gynecology Hospital,Changchun Jilin 130000,China;Department of Cardiovascular Medicine,Lequn Campus,Jilin University First Hospital,Changchun Jilin 130000,China)

机构地区：[1]长春市妇幼保健院/长春市妇产医院麻醉科,吉林长春130000 [2]长春市妇幼保健院/长春市妇产医院超声科,吉林长春130000 [3]吉林大学第一医院乐群分院心血管内科,吉林长春130000

出　　处：《中国卫生标准管理》2024年第12期36-40,共5页China Health Standard Management

基　　金：吉林省卫生健康科技能力提升项目(2022LC130)。

摘　　要：目的研究胃超声结合身体质量指数(body mass index,BMI)用于指导行全麻剖宫产术术前禁食水时间的可行性。方法回顾性分析2012年1月—2022年12月在长春市妇幼保健院行全麻剖宫产术的450例孕产妇。根据孕产妇BMI增幅(△BMI)将其分为3组,A组△BMI<4 kg/m^(2),B组24 kg/m≤△BMI≤6 kg/m^(2),C组△BMI>6 kg/m^(2)。食用相同食物,比较3组胃排空能力及预后。结果A组禁食水时间为(6.85±1.53)h,B组禁食水时间为(7.49±1.46)h,C组禁食水时间为(7.84±1.24)h,3组禁食水时间比较,差异有统计学意义(P<0.05);3组Ⅱ、Ⅲ期及产前T1、T3、T4各时间点胃窦横截面积(cross-sectional area,CSA)比较,差异有统计学意义(P<0.05);3组妊娠结局[巨大儿、转入新生儿重症监护室(neonatal intensive care unit,NICU)、新生儿窒息]及口渴、饥饿感评分比较,差异有统计学意义(P<0.05);C组首次排气时间长于A组、B组,满意度评分低于A组与B组(P<0.05)。结论超声引导下胃窦部CSA可更精准地判定产妇的胃内容量,从而预判术前禁食水时间,改善妊娠结局。Objective To study the feasibility of ultrasonography combined with body mass index(BMI)to guide the duration of water fasting before caesarean section under general anesthesia.Methods A retrospective analysis was performed on 450 pregnant women who underwent general anesthesia cesarean section in Changchun Maternal and Child Health Hospital from January 2012 to December 2022.According to the increase of BMI(△BMI),pregnant women were divided into 3 groups,group A△BMI<4 kg/m^(2),2 group B 4 kg/m≤△BMI≤6 kg/m^(2),and group C△BMI>6 kg/m^(2),eating the same food,and the gastric empting capacity and prognosis of the three groups were compared.Results The guiding water fasting time of group A was(6.85±1.53)h,group B was(7.49±1.46)h,and group C was(7.84±1.24)h,and the difference between the three groups was statistically significant(P<0.05).The cross-sectional area(CSA)of the gastric antrum in the three groups showed statistical significance at T1,T3 and T4 time points during the second,third,and prenatal stages(P<0.05).There were statistically significant differences in pregnancy outcomes[macrosomia,transfer to neonatal intensive care unit(NICU),neonatal asphyxia]and thirst and hunger scores among the three groups(P<0.05).The first exhaust time of Group C was longer than that of Group A and Group B,and the satisfaction score was lower than that of Group A and Group B(P<0.05).Conclusion The antral CSA guided by ultrasound can more accurately determine the gastric capacity of the pregnant women,so as to predict the time of fasting water before operation and improve the pregnancy outcome.

关 键 词：超声 胃窦横截面积 BMI 全麻剖宫产术 恶心呕吐 禁食水时间 

分 类 号：R711[医药卫生—妇产科学]