陈玲坤 杨玉婷 黄理进 苏薇 陈海林

【摘要】 目的：探討胃超声用于评估缩短麻醉前禁食时间的安全性。方法：回顾性分析2019年3月-2020年3月本院行气管插管全身麻醉下乳腺癌根治术治疗的80例患者的临床资料。根据其术前禁食禁饮情况的不同分为A组（禁食≥8 h，麻醉前2 h饮用葡萄糖，40例）、B组（禁食禁饮≥8 h，

40例）。两组均进行胃超声检查，比较两组患者舒适度、满意度、血糖水平、胃内容物返流误吸情况及麻醉耐受力。结果：T0时，两组收缩压（SBP）、舒张压（DBP）、心率（HR）比较，差异均无统计学意义（P>0.05）;T1、T2、T3时，A组SBP、DBP、HR均高于B组，差异均有统计学意义（P<0.05）。术前1 h及术后6 h，A组Kolcaba评分均高于B组，差异均有统计学意义（P<0.05）。术后，A组满意度高于B组，差异有统计学意义（P<0.05）。手术前1 h及手术结束时，A组Glu均高于B组，差异均有统计学意义（P<0.05）。术中A组胃内容物误吸返流率与B组比较，差异无统计学意义（P>0.05）。结论：较仅禁食禁饮≥8 h而言，禁食≥8 h及麻醉前2 h饮用葡萄糖能有效提升手术期间患者的麻醉耐受力，血糖水平较高，减少对患者的舒适程度的影响，患者术后满意度明显增加，且通过胃超声检查明确单位体积内胃容量，术中胃内容物返流误吸情况也无明显增加，安全性能较高。

【关键词】 乳腺癌根治术 胃超声 安全性 舒适度 满意度 胃内容物返流误吸率

Evaluate the Safety of Gastric Ultrasound for Shortening the Fasting Time before Anesthesia/CHEN Lingkun， YANG Yuting， HUANG Lijin， SU Wei， CHEN Hailin. //Medical Innovation of China， 2021， 18（07）： 0-014

[Abstract] Objective： To explore the safety of gastric ultrasound for evaluating the reduction of fasting time before anesthesia. Method： The clinical data of 80 patients who received radical mastectomy for breast cancer under tracheal intubation and general anesthesia in our hospital from March 2019 to March 2020 were retrospectively analyzed. The patients were divided into group A （fasting ≥8 h and drinking glucose 2 h before anesthesia， 40 cases） and group B （fasting ≥8 h， 40 cases） according to their preoperative fasting and drinking abstinence. Gastric ultrasound was performed in both groups， the comfort， satisfaction， blood glucose level， gastric content reflux aspiration and anesthesia tolerance were compared between the two groups. Result： At T0， there were no significant differences in systolic blood pressure （SBP）， diastolic blood pressure （DBP） and heart rate （HR） between the two groups （P>0.05）. At T1， T2 and T3， SBP， DBP and HR in group A were higher than those in group B， with statistical significance （P<0.05）. 1 h before surgery and 6 h after surgery， the Kolcaba score of group A was higher than that of group B， with statistical significance （P<0.05）. After surgery， the satisfaction of group A was higher than that of group B， the difference was statistically significant （P<0.05）. 1 h before and after surgery， Glu in group A was higher than that in group B， with statistical significance （P<0.05）. There was no statistical significance in the rate of gastric contents aspiration and reflux between group A and group B during operation （P>0.05）. Conclusion： Compared with fasting for more than 8 h and drinking glucose 2 h before anesthesia， fasting for more than 8 h and drinking glucose 2 h before anesthesia can effectively improve the anesthesia tolerance of patients during operation， the higher the blood glucose level， the less the impact on the comfort of patients， the higher the postoperative satisfaction of patients， and the gastric volume per unit volume by gastric ultrasound examination， the reflux and aspiration of gastric contents during the operation also did not increase significantly， the higher the safety performance.

[Key words] Radical mastectomy for breast cancer Gastric ultrasound Safety Comfort Satisfaction Rate of inhalation of gastric contents reflux

First-authors address： Maoming City Peoples Hospital， Maoming 525000， China

doi：10.3969/j.issn.1674-4985.2021.07.003

乳腺癌是一种发生在乳腺腺上皮组织的一种恶性肿瘤，如果不及时采取治疗，病情发展到后期会直接导致患者死亡[1]。当前，运用手术来切除乳腺是针对乳腺癌最常用的治疗方案，乳腺癌根治术是乳腺癌外科手术的标准术式[2-4]。一般而言，乳腺癌根治术治疗时均要行气管插管全身麻醉，且麻醉前需要禁食，预防胃内容物返流误吸导致吸入性肺炎。传统术前需禁食8～12 h，禁饮4 h，而在快速康复外科发展的今天有研究指出，过长时间禁食没必要且会带来许多危害，而缩短麻醉前禁食时间有利于手术后康复[5-6]。当前……