怀孕期间的胃空化及其临床影响:叙述性综述
Jacob Lawson1, Ryan Howle2, Petar Popivanov3
1Department of Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, London, UK.
British journal of anaesthesia
|October 23, 2024
概括
怀孕可以延迟胃排空,增加剖腹产麻醉期间吸收风险. 在分娩过程中,胃空气是不可预测的,胃超声波可能对孕妇有价值.
科学领域:
- 麻醉学 麻醉学
- 产科 产科 产科 产科 产科
- 胃肠病学 胃肠病学
背景情况:
- 延迟胃排空会在剖腹产麻醉期间造成肺吸气的严重风险.
- 怀孕显著影响胃排空,对麻醉管理有影响.
研究的目的:
- 审查怀孕对胃空化的不同阶段的影响,包括三个月,分娩和产后.
- 评估孕妇胃排空指数的液体,固体和禁食状态.
主要方法:
- 一篇关于32项观察性研究,1项非随机对照研究和22项随机对照试验的叙述性综述.
- 评估各种妊娠状态和不同摄入后的胃排空指数.
主要成果:
- 与非怀孕状态相比,胃空气在第一季度减少,但在第二和第三季度没有显著变化.
- 胃空气在分娩过程中被延迟,受到止痛的影响;全身阿片类药物会延迟,而外周止痛和内止痛有不同的效果.
- 即使在禁食后,分娩的妇女也可能有高风险的胃内容;关于分娩后胃空化的证据是相互矛盾的.
结论:
- 怀孕期间的胃排空是不可预测的,这凸显了剖腹产麻醉期间的潜在风险.
- 胃超声波可能是一个有价值的工具来评估孕妇的胃含量,特别是在分娩期间和剖腹产前.
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