Zhou Xiangyong, Tao Jiachun, Yao Yuanyuan, Luo Ge, Rui Min, Yan Min
Department of Anesthesiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310009, People's Republic of China.
Risk Manag Healthc Policy. 2025 Aug 31;18:2851-2863. doi: 10.2147/RMHP.S522663. eCollection 2025.
Aspiration of gastric contents is the major cause of respiratory tract-related complications, which can lead to death. Despite its significance, nationwide research on the practice of managing gastric regurgitation and pulmonary aspiration remains inadequate. We aimed to conduct a national survey to gain an in-depth understanding of the management and clinical practices surrounding perioperative gastric regurgitation and pulmonary aspiration among anesthesiologists in China.
A 26-item questionnaire was sent to all registered anesthesiologist members via WeChat and the New Youth Anesthesia Forum website.
A significant portion (70.77%) of respondents reported having encountered gastric regurgitation or pulmonary aspiration, with 50.15% experiencing cases where both regurgitation and aspiration occurred. While most patients had a favorable prognosis following aspiration, 20.63% and 20.72% of respondents indicated that their patients developed severe pneumonia or died as a result. Regurgitation and aspiration events mainly occurred during emergency surgery (86.39%), with abdominal operation (78.86%) being the most common. The induction of general anesthesia was identified as the most common phase for these events (75.33%). Rapid sequence induction (RSI) was employed by 61.98% of respondents. While 59.97% of respondents reported that their departments provided training on regurgitation and aspiration, only 20.34% had training specifically in gastric ultrasound technology. Additionally, 41.63% of the respondents' institutions were equipped with gastric ultrasound devices. A small fraction (14.93%) of respondents were proficient in gastric ultrasound examination techniques, while 20.99% were completely unfamiliar with the technology.
Our survey revealed that gastric regurgitation and pulmonary aspiration, as major threats to the safety of perioperative patients, still pose significant challenges in the practice of anesthesia in China. There are still many deficiencies in management. Strengthening training and improving resource allocation, especially in the adoption and widespread use of gastric ultrasound technology, are the directions that need to be improved in the future.
胃内容物误吸是呼吸道相关并发症的主要原因，可导致死亡。尽管其具有重要意义，但全国范围内关于胃反流和肺误吸管理实践的研究仍不充分。我们旨在进行一项全国性调查，以深入了解中国麻醉医生对围手术期胃反流和肺误吸的管理及临床实践情况。
通过微信和新青年麻醉论坛网站向所有注册麻醉医生会员发送一份包含26个条目的问卷。
很大一部分（70.77%）受访者报告曾遇到胃反流或肺误吸情况，其中50.15%经历过反流和误吸同时发生的病例。虽然大多数患者误吸后预后良好，但分别有20.63%和20.72%的受访者表示其患者因误吸发生了重症肺炎或死亡。反流和误吸事件主要发生在急诊手术期间（86.39%），其中腹部手术（78.86%）最为常见。全身麻醉诱导期被确定为这些事件最常发生的阶段（75.33%）。61.98%的受访者采用快速顺序诱导（RSI）。虽然59.97%的受访者报告其所在科室提供了关于反流和误吸的培训，但只有20.34%接受过专门的胃超声技术培训。此外，41.63%的受访者所在机构配备了胃超声设备。一小部分（14.93%）受访者精通胃超声检查技术，而20.99%的受访者对该技术完全不熟悉。
我们的调查显示，胃反流和肺误吸作为围手术期患者安全的主要威胁，在中国麻醉实践中仍然构成重大挑战。管理方面仍存在许多不足。加强培训并改善资源配置，特别是在胃超声技术的采用和广泛应用方面，是未来需要改进的方向。
