目的研究胃超声结合身体质量指数(body mass index,BMI)用于指导行全麻剖宫产术术前禁食水时间的可行性。方法回顾性分析2012年1月—2022年12月在长春市妇幼保健院行全麻剖宫产术的450例孕产妇。根据孕产妇BMI增幅(△BMI)将其分为3组,A...目的研究胃超声结合身体质量指数(body mass index,BMI)用于指导行全麻剖宫产术术前禁食水时间的可行性。方法回顾性分析2012年1月—2022年12月在长春市妇幼保健院行全麻剖宫产术的450例孕产妇。根据孕产妇BMI增幅(△BMI)将其分为3组,A组△BMI<4 kg/m^(2),B组24 kg/m≤△BMI≤6 kg/m^(2),C组△BMI>6 kg/m^(2)。食用相同食物,比较3组胃排空能力及预后。结果A组禁食水时间为(6.85±1.53)h,B组禁食水时间为(7.49±1.46)h,C组禁食水时间为(7.84±1.24)h,3组禁食水时间比较,差异有统计学意义(P<0.05);3组Ⅱ、Ⅲ期及产前T1、T3、T4各时间点胃窦横截面积(cross-sectional area,CSA)比较,差异有统计学意义(P<0.05);3组妊娠结局[巨大儿、转入新生儿重症监护室(neonatal intensive care unit,NICU)、新生儿窒息]及口渴、饥饿感评分比较,差异有统计学意义(P<0.05);C组首次排气时间长于A组、B组,满意度评分低于A组与B组(P<0.05)。结论超声引导下胃窦部CSA可更精准地判定产妇的胃内容量,从而预判术前禁食水时间,改善妊娠结局。展开更多
Anesthesiologists perform a broad spectrum of tasks. However, in many countries, there is no legal basis for personnel staffing of physicians in anesthesia. Also, the German diagnosis related groups system for refundi...Anesthesiologists perform a broad spectrum of tasks. However, in many countries, there is no legal basis for personnel staffing of physicians in anesthesia. Also, the German diagnosis related groups system for refunding does not deliver such a basis. Thus, in 2006 a new calculation base for the personnel requirement that included an Excel calculation sheet was introduced by the German Board of Anesthesiologists(BDA) and the German Society of Anesthesiology and Intensive Care Medicine(DGAI), and updated in 2009 and 2015. Oriented primarily to organizational needs, in 2015, BDA/DGAI defined quantitative and qualitative cornerstones for personnel requirement of physicians in anesthesia, especially reflecting recent laws governing physician's working conditions and competence in the field of anesthesia, as well as demands of strengthened legal rights of patients, patient care and safety. We present a workload-oriented model, integrating core working hours, shift work or standby duty, quality of care, efficiency of processes, legal, educational, controlling, local, organizational and economic aspects for calculating personnel demands. Auxiliary tables enable physicians to calculate personnel demands due to differing employee workload, non-patient oriented tasks and reimbursement of full-equivalents due to parental leave, prohibition of employment, or longterm illness. After 10 years of experience with the first calculation tool, we report the generalizable key aspects and items of a necessary calculation tool which may help physicians to justify realistic workload-oriented personnel staffing demands in anesthesia. A modular, flexiblenature of a calculation tool should allow adaption to the respective legal and organizational demands of different countries.展开更多
文摘Anesthesiologists perform a broad spectrum of tasks. However, in many countries, there is no legal basis for personnel staffing of physicians in anesthesia. Also, the German diagnosis related groups system for refunding does not deliver such a basis. Thus, in 2006 a new calculation base for the personnel requirement that included an Excel calculation sheet was introduced by the German Board of Anesthesiologists(BDA) and the German Society of Anesthesiology and Intensive Care Medicine(DGAI), and updated in 2009 and 2015. Oriented primarily to organizational needs, in 2015, BDA/DGAI defined quantitative and qualitative cornerstones for personnel requirement of physicians in anesthesia, especially reflecting recent laws governing physician's working conditions and competence in the field of anesthesia, as well as demands of strengthened legal rights of patients, patient care and safety. We present a workload-oriented model, integrating core working hours, shift work or standby duty, quality of care, efficiency of processes, legal, educational, controlling, local, organizational and economic aspects for calculating personnel demands. Auxiliary tables enable physicians to calculate personnel demands due to differing employee workload, non-patient oriented tasks and reimbursement of full-equivalents due to parental leave, prohibition of employment, or longterm illness. After 10 years of experience with the first calculation tool, we report the generalizable key aspects and items of a necessary calculation tool which may help physicians to justify realistic workload-oriented personnel staffing demands in anesthesia. A modular, flexiblenature of a calculation tool should allow adaption to the respective legal and organizational demands of different countries.
