超声评估结肠镜检查前胃排空的临床研究

The clinical study of evaluating gastric emptying by ultrasound prior colonoscopy

目的探讨一种利用超声评估结肠镜检查前胃排空情况的新方法及其临床应用效果。方法2013年1月—2015年12月在某部队医院就诊且拟行结肠镜检查的30例患者纳入研究。所有患者均在结肠镜检查当日给予磷酸钠片剂进行肠道准备,磷酸钠片剂(4片/次)加250 ml水,间隔15 min/次,共3次。通过Perlas的计算公式每15 min评估一次胃容积。最后一次服用磷酸钠片后6 h内实施结肠镜检查。结果最大胃窦容积为212 ml,出现在最后一次服药后15min。在服药后的6 min、120 min和150 min胃窦容积低于20 ml的发生率分别为24%、67%和92%。81%的患者每个结肠段的波士顿分数等于2或3。结论超声评估胃容积是一种简单和可靠的评估胃排空的方法。在结肠镜检查前2 h利用磷酸钠片肠道准备,胃排空状态可进行全身麻醉。

Objective To explore the clinical effect of ultrasonic evaluation of gastric emptying before colonoscopy.Methods The 30 patients in Beijing Renhe 2015 hospital between January 2013 to December 2015 were enrolled in this study.All the patients had a validated indication for colonoscopy and a preparation using sodium phosphate(NaP)tablets.The day of the procedure,patients took 4 tablets/time with 250 ml of water,then every 15 min;totalled three times.The gastric volume was estimated every 15 min according to the formula of Perlas(Anesthesiology,2009).Colonoscopy was performed on within the 6 h following the last intake.Results In all 30 patients.The maximum volume of the antrum was 212 ml,achieved 15 min after the last intake.24%,67%and 92%of subjects had an antral volume below 20 ml at 60,120 and 150 min,respectively.81%of patients had a Boston score equal to 2 or 3 in each colonic segment.Conclusion Gastric volume evaluation by using ultrasound appeared to be a simple and reliable.Data allow considering the NaP tablets bowel preparation in the morning of the procedure and confirming that gastric emptying is achieved after two hours,allowing patients receiving general anaesthesia.