超声测量与胃镜实测摄入导泻液后胃内容量的时间-容量关系及一致性分析  

Time-volume relationship and consistency analysis of gastric volume measured by ultrasonography and gastroscopy after consuming cathartic solution

作　　者：王洲武 杜瑞明[1] 郑镇伟[1] 陈露[1] 郑少坤[1] 郑若婷 WANG Zhouwu;DU Ruiming;ZHENG Zhenwei;CHEN Lu;ZHENG Shaokun;ZHENG Ruoting(Department of Anesthesiology,the Second Affiliated Hospital of Shantou University Medical College,Shantou 515041,China)

机构地区：[1]汕头大学医学院第二附属医院麻醉科,广东省汕头市515041

出　　处：《临床麻醉学杂志》2024年第12期1246-1251,共6页Journal of Clinical Anesthesiology

基　　金：汕头市医疗卫生科技计划项目(汕府科〔2023〕68号-53)。

摘　　要：目的通过超声评估结合胃镜抽吸研究患者饮用导泻液后胃内容量的变化并比较两种测量方法的一致性。方法选择按照2 L聚乙二醇(PEG)方案饮用导泻液的非插管全麻下胃肠镜检查患者205例,男108例,女97例,年龄18~75岁,BMI 18.5~30.0 kg/m^(2),ASAⅠ或Ⅱ级,按照禁饮时间随机分为五组:2 h~2 h 25 min组(2 h组,n=40)、2 h 30 min~2 h 55 min组(2.5 h组,n=42)、3 h~3 h 25 min组(3 h组,n=41)、3 h 30 min~3 h 55 min组(3.5 h组,n=41)、4 h~4 h 25 min组(4 h组,n=41)。麻醉前使用超声测量患者胃窦横截面积(CSA)并用Perlas公式计算胃内容量,随后在胃镜检查时抽吸胃内液体获得实测胃内容量。观察胃内容量随禁饮时间的变化,采用Spearman检验分析两者的相关性,并采用Bland-Altman检验分析超声评估胃内容量与实测胃内容量的一致性。结果五组超声评估胃内容量以及实测胃内容量差异均无统计学意义,实测胃内容量与禁饮时间之间无明显相关(P=0.729,r=-0.031,95%CI-0.167~0.106)。Perlas公式计算值与实测值的平均误差为37.7 ml(95%CI 33.8~41.7 ml),95%一致性界限为-18.0~94.0 ml,计算值明显高于实测值(P<0.05)。结论在饮用完2 L导泻液后的2 h~4 h 25 min,胃内容量并不随禁饮时间缩短而增加。Perlas公式计算的超声测量胃内容量明显高于实际测量的胃内容量。Objective To study the changes of gastric volume after drinking cathartic solution by ultrasound evaluation combined with gastroscopic aspiration,and to compare the consistency of the two measurement methods.Methods A total of 205 patients,108 males and 97 females,aged 18-75 years,BMI 18.5-30.0 kg/m^(2),ASA physical statusⅠorⅡ,were selected to undergo painless gastrointestinal endoscopy after consuming cathartic solution according to 2 L polyethylene glycol(PEG)regimen.Patients were randomly divided into five groups based on fasting time:2 hours-2 hours 25 minutes group(2 hours group,n=40),2 hours 30 minutes-2 hours 55 minutes group(2.5 hours group,n=42),3 hours-3 hours 25 minutes group(3 hours group,n=41),3 hours 30 minutes-3 hours 55 minutes group(3.5 hours group,n=41),4 hours-4 hours 25 minutes group(4 hours group,n=41).Before anesthesia,ultrasound was used to measure the cross-sectional area(CSA)of the gastric antrum and calculated gastric volume using the Perlas formula.Subsequently,gastric fluid was aspirated during gastroscopy to obtain the actual gastric volume.The changes of gastric volume with fasting time were observed,and the correlation between them was analyzed by Spearman test.Bland-Altman analysis was used to assess the consistency between the ultrasound-assessed gastric volume and the actual gastric volume.Results There was no significant difference in the ultrasound-assessed gastric volume and the actual gastric volume among the five groups,and no significant correlation between the actual gastric volume and the fasting time(P=0.729,r=-0.031,95%CI-0.167 to 0.106).The mean difference between the Perlas formula-calculated values and the actual values was 37.7 ml(95%CI 33.8 to 41.7 ml),and the range of 95%limits of agreement was-18.0 to 94.0 ml.The calculated values was significantly higher than the actual values(P<0.05).Conclusion From 2 hours to 4 hours and 25 minutes after consuming 2 L cathartic solution,the gastric volume did not increase with the shortening of fasting time.The ultrasound-

关 键 词：超声 胃内容物 胃肠镜 肺误吸 禁食 

分 类 号：R614[医药卫生—麻醉学]