超声测量胃窦部横截面积评估学龄前患儿术前胃内容物容量的价值

Value of ultrasonographic measurement of antral cross-sectional area in assessing preoperative gastric content volume in preschool pediatric patients

目的 评价超声测量胃窦部横截面积评估学龄前患儿术前胃内容物容量的价值.方法 择期行非胃肠道手术的患儿50例,年龄〈7岁,性别不限,ASA分级Ⅰ或Ⅱ级,术前按照ASA推荐的标准进行禁食.入室后,静脉注射咪达唑仑镇静或咪达唑仑复合丙泊酚镇静,开放轨迹法床旁胃部超声测量仰卧位和右侧卧位下胃窦部横截面积,超声检查后置胃管抽取胃液,其总量即为胃内容物容量.结果 6例患儿因胃窦部超声图像不满意剔除本研究,最终44例患儿纳入本研究.胃内容物容量和每公斤体重胃内容物容量与右侧卧位下胃窦部横截面积呈正相关,Spearman相关系数分别为0.48 （P〈0.01）和0.37 （P〈0.05）;胃内容物容量和每公斤体重胃内容物容量与平卧位下胃窦部横截面积无相关性（P〉0.05）.结论 右侧卧位下超声测量胃窦部横截面积可用于评估学龄前儿童术前胃内容物的容量.

Objective To evaluate the value of ultrasonographic measurement of the antral crosssectional area （CSA） in assessing the preoperative gastric content volume in preschool pediatric patients.Methods Fifty American Society of Anesthesiologists physical status Ⅰ or Ⅱ pediatric patients of both sexes,aged 〈7 yr,undergoing elective non-gastrointestinal surgery,were fasted according to the preoperative fasting guidelines recommended by American Society of Anesthesiologists.Sedation was performed with intravenously injected midazolam or with intravenously injected midazolam and propofol after admission to the operating room.The antral CSA in the supine and right lateral decubitus positions was measured using bedside ultrasonography and free tracing method.A gastric tube was inserted after gastric sonography to collect the gastric fluid,and the total volume of the gastric fluid was considered to be the gastric content volume.Results Six pediatric patients were excluded due to the unsatisfactory ultrasound image,and 44 pediatric patients were included.Gastric content volume and gastric content volume per kilogram of body weight were positively correlated with the antral CSA in the right lateral decubitus position,and the Spearman correlation coefficients were 0.48 （P〈0.01） and 0.37 （P〈0.05）,respectively.There was no correlation between gastric content volume and gastric content volume per kilogram of body weight and the antral CSA in the supine position （P〉0.05）.Conclusion Ultrasonographic measurement of the antral CSA in the right lateral decubitus position can be used to assess the preoperative gastric content volume in preschool pediatric patients.