0超声评估胃内容物

高回声)Р肌层固有层(低回声区,通常最厚的胃壁层)Р浆膜层(薄,高回声)Р鉴别胃内容物Р清亮无渣液体:Р均匀一致的低回声Р胃壁逐渐变薄,胃窦膨胀,形状近似卵圆形Р多发的空气气泡在低回声充满液体的胃腔内呈现出高回声的点状现象,犹如“繁星之夜”Р粘稠液体或悬浮液(如牛奶):Р胃窦形状与清亮液体相似,但其多为均匀一致的高回声Р固体:Р初期:“磨玻璃样”(A)Р90min后:混合性强回声(B) Р测量胃内容量Р胃窦部横截面积(antral cross-sectional area,CSA)Р采用双径线法:CSA=(×π)/4Р(为胃窦部头骶径)Р估算胃内容量(stomach volume,GV):BMI<40,上限500mlРGV (ml)=27.0+14.6×右侧卧位CSA−1.28×年龄Р特殊人群:Р孕妇:3级评价系统Р0级胃内无液体Р1级仅在右侧卧位可见液体Р2级仰卧位和右侧卧位均可见液体Р儿童:3级评价系统也适用РGV (ml)=-7.8+3.5×右侧卧位CSA+0.127×年龄(月份)Р参考:РPerlas A, Mitsakakis N, Liu L, et al. Validation of a mathematical model for ultrasound assessment of gastric volume by gastroscopic examination[J]. Anesthesia & Analgesia, 2013, 116(2): 357-363.РVan de Putte P and Perlas A. Ultrasound assessment of gastric content and volume[J]. British Journal of Anaesthesia, 2014, 113 (1):12-22.Р (编写责任人:宋伟)