胃容积在糖尿病患者腹腔镜盆腔手术后反流误吸中的预警价值  

Significance of Quantitative Ultrasound Evaluation Based on Gastric Contents in Early Warning of Reflux Aspiration in Patients with Diabetes After Laparoscopic Pelvic Surgery

作　　者：陈学良 荆凤娥 王国玉 苏文涛 周侃 李秀娜 卢小迎 崔修德 CHEN Xueliang;JING Feng’e;WANG Guoyu;SU Wentao;ZHOU Kan;LI Xiuna;LU Xiaoying;CUI Xiude(Department of Anesthesia Surgery,the First Affiliated Hospital of Henan Polytechnic University,Jiaozuo 454000,China)

机构地区：[1]河南理工大学第一附属医院麻醉手术部,河南焦作454000

出　　处：《河南医学研究》2025年第4期619-623,共5页Henan Medical Research

基　　金：焦作市2022年科技计划项目(202223014)。

摘　　要：目的探讨基于胃内容物的超声定量评价在糖尿病患者腹腔镜盆腔手术后反流误吸预警中的意义。方法选取2021年9月至2023年4月河南理工大学第一附属医院收治的1200例腹腔镜盆腔手术患者,根据其是否发生饱胃分为发生组(120例)与未发生组(1080例)。分析其饱胃影响因素及胃容积(GV)与腹腔镜盆腔手术患者饱胃影响因素的交互作用,比较糖尿病腹腔镜盆腔手术后发生与未发生反流误吸患者GV,评价GV在糖尿病患者腹腔镜盆腔手术后反流误吸预警中的应用价值。结果合并糖尿病、麻醉时长、诱导前GV均为腹腔镜盆腔手术发生饱胃的独立影响因素(P<0.05)。诱导前GV与合并糖尿病存在交互作用(P<0.05)。;糖尿病腹腔镜盆腔手术后发生反流误吸患者诱导前、拔管前、拔管后GV大于未发生患者(P<0.05)。受试者工作特征(ROC)曲线显示,诱导前GV预测糖尿病患者腹腔镜盆腔手术后反流误吸的AUC值最大,明显高于拔管前、拔管后(P<0.05)。结论于诱导前、拔管前、拔管后进行基于胃内容物的超声定量评价在糖尿病患者腹腔镜盆腔手术后反流误吸预警中具有重要意义,且诱导前意义最大。Objective To explore the significance of ultrasonic quantitative evaluation based on gastric contents in the early warning of reflux aspiration in patients with diabetes after laparoscopic pelvic surgery.Methods A total of 1200 patients undergoing laparoscopic pelvic surgery in the First Affiliated Hospital of Henan Polytechnic University from September 2021 to April 2023 were selected and grouped according to whether they experienced satiation or not,with the occurrence group(120 cases)versus the non-occurrence group(1080 cases).The interaction of their satiety influencing factors and gastric volume(GV)with satiety influencing factors in laparoscopic pelvic surgery patients was analysed to compare GV in patients with and without occurrence of reflux misaspiration after laparoscopic pelvic surgery in diabetic patients and to evaluate the value of GV in the early warning of reflux misaspiration after laparoscopic pelvic surgery in diabetic patients.Results The combination of diabetes,duration of anesthesia and GV before induction were all independent influencing factors for the occurrence of satiety in laparoscopic pelvic surgery(P<0.05).There was interaction between GV before induction and diabetes(P<0.05).GV before induction,before extubation,and after extubation in patients with diabetes who had reflux aspiration after laparoscopic pelvic surgery was greater than that in patients without reflux aspiration(P<0.05).The receiver operating characteristic(ROC)curve of the subjects showed that the AUC value of GV before induction predicting reflux aspiration after laparoscopic pelvic surgery in diabetes patients was the largest,significantly higher than that before and after extubation(P<0.05).Conclusion Quantitative ultrasound evaluation based on gastric contents before induction,before and after extubation is important in the early warning of reflux aspiration after laparoscopic pelvic surgery in diabetic patients,with the greatest significance before induction.

关 键 词：胃内容物 超声定量评价 糖尿病 腹腔镜盆腔手术 反流误吸 

分 类 号：R614[医药卫生—麻醉学]