妊娠因素对液体胃排空的影响:超声法测定

Effect of pregnancy on gastric emptying of fluid: measurement using ultrasound

目的采用超声法评价妊娠因素对液体胃排空的影响。方法选择足月妊娠的产妇30例,年龄20~40岁,ASA分级Ⅰ或Ⅱ级。根据饮用液体不同分为2组(n=15):清水组(N组)和碳水化合物饮料组(S组)。试验前禁食≥8h,禁饮≥2h。N组饮用清水200ml,S组饮用碳水化合物饮料200ml。取半坐位,采用床旁超声获取胃窦部图像,分别于空腹状态下、饮用液体结束即刻、饮用液体结束后30、60和120min时测定胃窦部头尾径及前后径,计算胃窦部横截面积。测得的胃窦部横截面积小于或等于T0时胃窦部横截面积即为胃排空。结果2组产妇饮用液体结束后120min时胃排空率均为100%。与N组比较,S组饮用液体结束后60min时胃排空率降低(P<0.05)。结论足月妊娠产妇饮用清水和碳水化合物饮料后均能在2h内达胃排空状态。

Objective To evaluate the effect of pregnancy on gastric emptying of fluid using ultrasound. Methods Thirty parturients who were at full term, aged 20-40 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, were divided into 2 groups (n=15 each) according to the liquid ingested: clear water group (N group) and carbohydrate beverage group (S group). Parturients underwent food fasting ≥8 h and water fasting≥2 h. Parturients ingested clear water 200 ml in N group and carbohydrate beverage 200 ml in S group.The antral cross-sectional area (CSA) was measured in the semi-sitting position using bedside ultrasonography in the fasting state (T0), immediately after ingesting liquids (T1), and at 30, 60 and 120 min after the end of ingesting liquids (T2-4). Gastric emptying was defined as the antral CSA measured less than or equal to the antral CSA at T0. ResultsThe rate of gastric emptying was all 100% at T4 between two groups.Compared with group N, the rate of gastric emptying was significantly decreased at T3 in group S (P<0.05). Conclusion Gastric emptying of fluid is achieved within 2 h after ingesting clean water or carbohydrate beverage in parturients who are at full term, and gastric emptying is delayed after ingesting carbohydrate beverage compared with that after ingesting clean water.