[1]傅 蕊,李士欣,周国强,等.床旁超声预测慢性乙型肝炎患者胃镜检查围麻醉期误吸风险的临床价值[J].医学信息,2019,32(08):123-125.[doi:10.3969/j.issn.1006-1959.2019.08.035]
　FU Rui,LI Shi-xin,ZHOU Guo-qiang,et al.Clinical Value of Bedside Ultrasound in Predicting the Risk of Aspiration during Perioperative Anesthesia in Patients with Chronic Hepatitis B[J].Journal of Medical Information,2019,32(08):123-125.[doi:10.3969/j.issn.1006-1959.2019.08.035]
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床旁超声预测慢性乙型肝炎患者胃镜检查围麻醉期误吸风险的临床价值()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
32卷
期数:
2019年08期
页码:
123-125
栏目:
临床研究
出版日期:
2019-04-15

文章信息/Info

Title:
Clinical Value of Bedside Ultrasound in Predicting the Risk of Aspiration during Perioperative Anesthesia in Patients with Chronic Hepatitis B
文章编号:
1006-1959（2019）08-0123-03
作者:
傅 蕊1; 李士欣2; 周国强1; 李依泽3
（1.天津第二人民医院麻醉科，天津 300192；2.天津医科大学总医院急诊医学科，天津 300052；3.天津医科大学总医院麻醉科，天津 300052）
Author(s):
FU Rui1; LI Shi-xin2; ZHOU Guo-qiang1; LI Yi-ze3
(1.Department of Anesthesiology,Tianjin Second People's Hospital,Tianjin 300192,China;2.Department of Emergency Medicine,Tianjin Medical University General Hospital,Tianjin 300052,China;3.Department of Anesthesiology,Tianjin Medical University General Hospital,Tianjin 300052,China)
关键词:
床旁超声; 慢性乙型肝炎; 麻醉; 误吸
Keywords:
Bedside ultrasound; Chronic hepatitis B; Anesthesia; Aspiration
分类号:
R614
DOI:
10.3969/j.issn.1006-1959.2019.08.035
文献标志码:
A
摘要:
目的 研究床旁超声检查仰卧位下胃窦评估围麻醉期慢性乙型肝炎患者误吸风险的临床价值。方法 选择我院接受常规胃镜检查的慢性乙型肝炎患者200例，依据胃镜所见胃内容物性质将患者分为固体组与液体组，利用四个表判断床旁超声定性分组可靠性；按照收集胃液量，将胃镜判定液体组患者分为空腹组（≤0.8 ml/kg）与非空腹组（＞0.8 ml/kg），比较胃窦横截面积（CSA）组间差异。结果 200例患者中，胃镜分组固体组17例（床旁超声分组固体组7例，非固体组10例），液体组183例（床旁超声分组固体组2例，非固体组181例），床旁超声诊断胃内含有固体内容物的阳性预测值与阴性预测值分别为77.78%和94.76%，诊断符合率94.00%。胃镜液体组中含空腹组160组和非空腹组23例，床旁超声测量胃窦CSA组间差异显著[（4.83±1.04）cm2 vs （5.90±1.60）cm2，P＜0.01]。结论 床旁超声检查仰卧位下胃窦可准确判断慢性乙型肝炎患者胃内容物情况，指导临床麻醉医生评估围麻醉期误吸风险。
Abstract:
Objective To evaluate the clinical value of bedside ultrasonography in evaluating the risk of aspiration in patients with chronic hepatitis B during peri-anaesthesia. Methods A total of 200 patients with chronic hepatitis B who underwent conventional gastroscopy were selected. The patients were divided into solid group and liquid group according to the nature of gastric contents seen by gastroscope. Four tables were used to judge the reliability of bedside ultrasound qualitative grouping. The amount of gastric juice was divided into two groups: the fasting group (≤0.8 ml/kg) and the non-fasting group (>0.8 ml/kg). The difference in gastric sinus cross-sectional area (CSA) was compared. Results Of the 200 patients, 17 were in the gastroscopy group (7 in the bedside ultrasound group, 10 in the non-solid group),183 in the fluid group (2 in the bedside ultrasound group, 181 in the nonsolid group). The positive predictive value and negative predictive value of bedside ultrasound diagnosis of solid contents in the stomach were 77.78% and 94.76%, respectively, and the diagnostic coincidence rate was 94.00%. In the gastroscope group, there were 160 patients in the fasting group and 23 patients in the non-fasting group. The difference between the bedside ultrasound and the gastric sinus CSA group was significant [(4.83±1.04) cm2 vs (5.90±1.60) cm2,P<0.01]. Conclusion Bedside ultrasound examination of the lower antrum of the supine position can accurately determine the gastric contents of patients with chronic hepatitis B, and guide the clinical anesthesiologist to assess the risk of aspiration during the anesthesia period.

参考文献/References:

[1]Perlas A,Arzola C,Putte PVD.Point-of-care gastric ultrasound and aspiration risk assessment:a narrative review[J].Candian Journal of Anesthesia,2018,65(4):437-448. [2]Ayhan K,Erhan G.Preoperative Assessment of Ultrasonographic Measurement of Antral Area for Gastric Content[J].Med Sci Monit,2018,24(8):5542-5548. [3]Sebrechts T,Perlas A,Abbas S,et al.Serial Gastric Ultrasound to Evaluate Gastric Emptying After Prokinetic Therapy With Domperidone and Erythromycin in a Surgical Patient With a Full Stomach:A Case Report[J]. A A Pract,2018,11(4):106-108. [4]Bouvet L,Desgranges FP,Aubergy C,et al.Prevalence and factors predictive of full stomach in elective and emergency surgical patients:a prospective cohort study[J].Br J Anaesth,2017,118(3):372-379. [5]蒋卫清,陈利海,谢欣宜,等.床旁超声快速评估胃内容物及容量的研究进展[J].临床麻醉学,2017,1(33):91-94. [6]Van de Putte P,Perlas A.Ultrasound assessment of gastric content and volume[J].Br J Anaesth,2014,113(1):12-22.

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更新日期/Last Update: 2019-04-15