摘要
目的胃内容物增多容易发生反流性误吸,显著增加患者围术期死亡率。目前缺乏有效的无创性的方法测量胃内容物,本研究旨在探讨超声测量胃容量及胃内容物性质的可行性。资料与方法前瞻性纳入54例健康志愿者,其中第I阶段研究18例,第II阶段研究36例。两组受试者均行超声检查,第I阶段受试者分别在禁食、饮水250 ml、饮水500 ml、饮起泡水500 ml、进食固体饮食后测量胃窦、胃体和胃底的截面。基于第I阶段研究的结果,选择胃窦作为超声观察截面。在第II阶段研究中,36名健康志愿者行胃窦超声检查,分析胃容量和胃窦截面面积的关系。结果胃窦完整图像获得率较胃体、胃底高,为72%~100%。当胃容量<300 ml时,胃窦截面面积与胃容量呈直线相关(P<0.001),右侧卧位时更为显著(校正R_(右侧卧位)~2=0.665,校正R_(仰卧位)~2=0.560)。胃容量预测公式为侧卧位容量(ml)=-372.54+282.49×log侧卧位截面面积-1.68×体重。结论当进食液体量<300 ml时,超声检查能反映胃内容物性质,并能评估胃容量,胃窦为最佳测量部位。
Purpose Aspiration of gastric contents significantly increases the perioperative mortality rate, and an effective non-invasive method is still unavailable to assess gastric contents. This study aims to investigate the feasibility of assessing gastric contents and its volume by using ultrosonography. Materials and Methods Fifty-four healthy volunteers were prospectively studied in 2 phases. In phase I, the cross-section area（CSA） of gastric antrum, body, and fundus were measured in 18 subjects under different conditions such as fasting, ingestion of 250 ml water, ingestion of 500 ml water, ingestion of 500 ml effervescent water, and a solid meal. In phase II, ultrasound examination of the gastric antrum in the rest 36 subjects was applied to determine the correlation between gastric volume and antral CSA. Results The gastric antrum was obtained the most reliable quantitative information for gastric volume evaluation compared with gastric body and fundus（CSA obtain rate 72%-100%）. The antral CSA was correlated with gastric volume in a close-to-linear fashion when the contents were less than 300 ml（P0.001）, particularly when the volunteers were in the right lateral decubitus position（CSA-lateral R^2=0.665 vs. CSA-supine R^2=0.560）. The formula of gastric contents assessment was as follows： volume（ml）=- 372.54＋282.49×log CSA-lateral- 1.68×weight. Conclusion Sonographic examination can provide qualitative information for gastric contents and its nature when the food or liquid taken is less than 300 ml; and the gastric antrum is the optimal monitoring site.
出处
《中国医学影像学杂志》
CSCD
北大核心
2016年第4期285-288,共4页
Chinese Journal of Medical Imaging
关键词
超声检查
胃排空
胃肠内容物
Ultrasonography
Gastric emptying
Gastrointestinal contents
