床旁胃超声评估剖宫产者围术期胃容量的临床价值

Clinical value of bedside gastric ultrasound in evaluating perioperative gastric volume in cesarean section patients

目的应用床旁胃超声评估剖宫产者围术期胃容量,分析不同体位下测得胃窦部横截面积(CSA)的差异。方法选择拟行剖宫产的足月妊娠产妇60例,入手术室后行床旁胃超声检查,观察胃内容物性质、容量并进行Perlas分级,测量并比较平卧位与右侧卧位胃窦CSA,分析胃窦容积与临床资料的相关性。结果Perlas分级为1级时,右侧卧位胃窦CSA为(2.63±0.40)cm^(2),仰卧位胃窦CSA为(4.33±0.75)cm^(2),二者比较差异有统计学意义(P<0.01);Perlas分级为0级、2级时,两种体位所测胃窦CSA比较,差异均无统计学意义。右侧卧位胃窦容积与年龄、体质量、体质量指数均呈正相关(r=0.350、0.270、0.286,P=0.006、0.037、0.027),与孕周无相关性。结论应用超声测量胃窦CSA可评估剖宫产者围术期胃容量,且右侧卧位测值较仰卧位更准确。

Objective To evaluate the perioperative gastric volume of cesarean section patients by bedside gastric ultrasound,and to analyze the difference of gastric antral cross-sectional area(CSA)measured in different positions.Methods Sixty full-term pregnant women who planned to undergo cesarean section were selected.After entering the operating room,bedside gastric ultrasound was performed to observe the nature and quantity of gastric contents and to perform Perlas grading.The gastric antral CSA was measured and compared between supine position and right lateral position,and the correlation between the volume of gastric antrum and clinical data was analyzed.Results When Perlas grade was 1,the gastric antral CSA was(2.63±0.40)cm^(2) in the right lateral position and(4.33±0.75)cm^(2) in the supine position,the difference was statistically significant(P<0.01).When Perlas grade was 0 or 2,there were no significant difference in gastric antral CSA of between the two positions.The gastric antral volume measured in the right lateral position was positively correlated with age,body mass and body mass index(r=0.350,0.270,0.286,P=0.006,0.037,0.027),but not with gestational week.Conclusion The gastric antral CSA measured by ultrasound can evaluate the gastric volume during the perioperative period of cesarean section,and the measurement value in the right lateral position is more accurate than that in the supine position.