胃超声在预防围术期小儿患者反流误吸中的临床应用

Clinical application of ultrasound-guided gastric content assessment in prevention of reflux aspiration in perioperative pediatric patients

目的:探讨胃超声在围术期预防小儿患儿反流误吸的效果。方法:选取50例12岁以下的需在全麻下急诊行阑尾切除术的患儿,采用随机数字表法分为常规麻醉组25例(C组)和胃超声组25例(U组)。C组患儿采用常规麻醉方法,U组患儿入室后使用超声评估患儿胃内容物,根据情况行粗大胃管置入吸引胃内容物,并于麻醉诱导前拔除胃管(此处理后再次评估胃内容物),然后快速序惯麻醉诱导。记录两组患儿一般情况,术前禁饮食时间,手术时间,反流误吸发生率,U组患儿胃超声耗用时间。结果:两组患儿一般情况、术前禁食时间、手术时间差异均无统计学意义(P>0.05);C组患儿有4例发生反流,显著大于U组患儿中的0例(P<0.05);两组患儿均未发生误吸;U组患儿胃超声评估的时间为(6.75±2.49)分。结论:胃超声技术应用于小儿急诊全麻下阑尾切除术可显著降低反流的发生率,提高其围术期的安全性。

Objective:To evaluate the effect of gastric ultrasound on prevention of reflux aspiration in pediatric patients during perioperative period.Methods:Fifty children under 12 years old scheduled for emergency appendectomy under general anesthesia,all genders,ages 1 to 12 years,ASA classⅠ-Ⅱ,were randomly allocated to receive either routine anesthesia(group C),or receive ultrasound to evaluate the gastric contents of the children,according to the situation,a bulging gastric tube was placed to attract gastric contents,then removed before induction of anesthesia(gastric contents were reassessed after this treatment),after that,induction of rapid sequence of habitual anesthesia(group U).General information of patients in the two groups,preoperative time of dietary abstinence,operative time,incidence of reflux aspiration,and consumption time of gastric ultrasound in group U were all recorded.Results No significant differences in general condition,preoperative fasting time and operative time between the two groups(P>0.05).Four cases of reflux in group C,which was significantly higher than that in group U(P<0.05).No aspiration occurred in 2 groups.Duration of gastric ultrasound evaluation in U group was 6.75±2.49 minutes.Conclusion:Gastric ultrasound in pediatric emergency appendectomy under general anesthesia can significantly reduce the incidence of reflux and improve its perioperative safety.