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强化胃超声在容量和内容评估方面的重要作用:一项观察性研究。

Reinforcing the valuable role of gastric ultrasound for volume and content assessment: an observational study.

机构信息

Centro Hospitalar Tondela-Viseu, Viseu, Portugal.

San Francisco de As.ís Hospital, Ultrasonography Unit, Ecographic Diagnostic Center, Madrid, Spain.

出版信息

Braz J Anesthesiol. 2022 Nov-Dec;72(6):749-756. doi: 10.1016/j.bjane.2021.07.008. Epub 2021 Jul 26.

Abstract

BACKGROUND

Pulmonary aspiration is one of the most important complications in anesthesiology. Assessment of gastric content by ultrasound is a good method to quantify gastric volume and to determine the risk of intraoperative pulmonary aspiration. The aim of this study is to determine the accuracy of the gastric ultrasonography in the qualitative analysis of gastric content, mainly in the analysis of small amounts of liquid content.

METHODS

Gastric ultrasound was performed to 36 patients before upper gastrointestinal endoscopy (UGI), making two longitudinal scans at the epigastric level, one in supine position and the other in right lateral decubitus position, measuring two diameters and the area of the gastric antrum and assessing the content characteristics determining whether it was an empty stomach or contained fluid or solid content. Subsequently, the ultrasound findings were compared with UGI findings.

RESULTS

Gastric areas were analyzed by the trace and the lengths of the craniocaudal and anteroposterior axes concluding that there are no significant differences between the two methods. No statistically significant difference was found between UGI and US assessment technics. No statistically significant difference was found between the estimated volume by UGI and US.

CONCLUSIONS

Though our study has some limitations, qualitative analysis of gastric content using ultrasound followed by endoscopy enabled the conclusion that there are no differences in the qualitative assessment regarding these two techniques, supporting the important role of point-of-care gastric ultrasound (POCGUS) in the assessment of pulmonary aspiration risk by the anesthesiologist in the perioperative period.

摘要

背景

吸入性肺炎是麻醉学中最重要的并发症之一。超声评估胃内容物是一种很好的方法,可以定量胃容量,并确定术中发生吸入性肺炎的风险。本研究的目的是确定胃超声在胃内容物定性分析中的准确性,主要是在分析少量液体内容物时。

方法

对 36 例拟行上消化道内镜(UGI)的患者进行胃超声检查,在上腹部进行两次纵向扫描,一次仰卧位,一次右侧卧位,测量胃窦的两个直径和面积,并评估内容物特征,确定是否为空胃或含有液体或固体内容物。随后,将超声检查结果与 UGI 检查结果进行比较。

结果

通过迹线和前后轴的长度分析胃面积,得出两种方法之间无显著差异。UGI 和 US 评估技术之间无统计学差异。UGI 和 US 估计的体积之间无统计学差异。

结论

尽管我们的研究存在一些局限性,但通过超声内镜对胃内容物进行定性分析,我们得出的结论是,这两种技术在定性评估方面没有差异,支持在围手术期由麻醉师进行床边胃超声(POCGUS)评估吸入性肺炎风险的重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bff/9659995/52cc974fc33c/gr1.jpg

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