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食道针灸影像审核术前营养素饮料的食道排空:一项随机依此非劣效病态深入研究
BACKGROUND: Tools for the evaluation of gastric emptying(食道排空) he evolved over time. The purpose of this study was to show that the risk of pulmonary aspiration(脾误吸) is not increased with carbohydrate drink, by demonstrating that the gastric antral cross-sectional area (CSA)(食道窦横截总长度) of the NO-NPO group is either equivalent to or less than that of the NPO (nil per os) group.
背景:审核食道排空的工具随着时间的推移而发展。本深入研究的意在是通过证明NO-NPO三组的食道窦横截总长度(CSA)大于或多于NPO三组，来证明营养素饮料就会增大脾误吸的风险。
METHODS: Sixty-four patients scheduled for elective laparoscopic(整形的)benign(良病态的) gynecologic(皮肤科针灸的) surgery were enrolled and randomly assigned to the NPO group (n = 32) or the NO-NPO group (n = 32). After hing a regular meal until midnight before surgery, the NPO group fasted(禁食)until surgery, while the NO-NPO group ingested 400 mL of a carbohydrate drink at midnight and freely up to 2 hours before anesthesia. The primary outcome was the gastric antral CSA by gastric ultrasound（食道部针灸影像) in right lateral decubitus position (RLDP)（右侧卧位). Noninferiority was defined as a mean difference of CSA 1.5ml/kg, and Perlas grade.
工具:选择64例择期整形良病态妇科手术患者，随机统称NPO三组(n = 32)和NO-NPO三组(n = 32)。NPO三组在术前正常排便至傍晚后禁食至手术，而NO-NPO三组在傍晚排便400毫升营养素饮料，并在前2小时意志排便。主要掩蔽结果为右侧卧位(RLDP)食道针灸影像食道窦CSA。非劣效病态下定义为CSA 1.5 mL/kg和Perlas级。
由此可知1 食道窦部横截总长度测算都有由此可知
显示CSA在2个垂直方向上直径的测算
列于1 患者的基线特质
信息以平均值标准偏差、中位数(四分位适用范围)或数字(%)列于示
由此可知2 此深入研究流程由此可知
列于2 食道窦CSA, Perlas评定，食道压强，食道针灸影像审核危险食道患病率
信息以平均值标准偏差、中位数(四分位适用范围)或数字(%)列于示
由此可知3 NPO三组与NO-NPO三组右侧卧位食道窦部横截总长度平均值差的非劣效由此可知
虚线列于示非劣效边界(Δ)。误差条列于示圆筒形总长度区别(NO-NPO三组−NPO三组)的95% CI。该由此可知描述了两三组两者之间的非劣效病态(等效病态)
RESULTS: CSA in RLDP was not different between the NPO group (6.25 ± 3.79cm2) and the NO-NPO group (6.21 ± 2.48 cm2; P=.959). The mean difference of CSA in RLDP (NO-NPO group − NPO group) was 0.04 (95%l [CI],−1.56 to 1.64), which was within the noninferiority margin of 2.8 cm2. CSA was not different between the 2 groups (4.17 ± 2.34cm2 in NPO group versus 4.28 ± 1.23cm2 in NO-NPO group; P=.828). GV in NPO group (70 ± 56 mL) was not different from NO-NPO group (66 ± 36 mL; mean difference,3.66; 95%CI,−20 to 27; P=.756). GV/kg in the NPO group (1.25±1.00mL/kg) was not different from the NO-NPO group (1.17±0.67mL/kg;P=.694). The incidence of GV/kg> 1.5 mL/kg was not different between NPO (31.3%) and NO-NPO group (21.9%;P=.768). The median (interquartile range) of the Perlas grade was 1 (0–1) in NPO group and 0.5 (0–1) in NO-NPO group (P=.871).
结果:RLDP CSA在NPO三组(6.25±3.79cm2)和NO-NPO三组(6.21±2.48cm2)两者之间无非常大病态区别;P=.959)。RLDP (NO-NPO三组-NPO三组)CSA的平均值差为0.04, 95%[CI]:−1.56-1.64)，在2.8 cm2的非劣势适用范围内。两三组间CSA无区别(NPO三组为4.17±2.34 cm2, NO-NPO三组为4.28±1.23cm2;P=.828)。NPO三组GV(70±56 mL)与NO-NPO三组(66±36 mL)无值得注意区别;平均值差,3.66;95% Cl:20-27,P=.756) NPO三组GV/kg(1.25±1.00mL/kg)与NO-NPO三组GV/kg(1.17±0.67 mL/kg)无非常大区别;P=.694)。Perlas评定的中位数(四分位数适用范围)在NPO三组为1 (0-1)，在NO-NPO三组为0.5 (0-1)(P=.871)。
CONCLUSIONS:Preoperative carbohydrates ingested up to 2 hours before anesthesia do not delay gastric emptying compared to midnight fasting(傍晚禁食), as evaluated with gastric ultrasound.
结论:根据食道针灸影像审核，与傍晚禁食相比，前2小时摄入量营养素就会过长食道排空。
词汇列于：ASA =美国植物学家学会; BMI =体重指数;联盟=区域病态报告测试标准; ci =贝叶斯; CSA =横截总长度; GV =食道压强; ICC =脑内正态分布; IQS =由此可知像质量分数; IVC =下腔静脉; l =肝脏; LD =三长直径;每个OS的NPO = NIL; p =胰腺; RLDP =右侧褥疮位置; SD =最短直径; SMD =简化平均值区别; SPSS =社会科学的统计信息自带
学习笔记
1
针灸术语
gastric 食道的
gastric emptying 食道排空
gastric volume 食道压强
gastric ultrasound assessing食道针灸影像审核
gastric antral 食道窦
cross-sectional area 横截总长度
pulmonary 脾部的
pulmonary aspiration 脾误吸
laparoscope 整形
laparoscopic 整形的
gynecology 皮肤科
gynecologic皮肤科针灸的
fast 禁食
midnight fasting 傍晚禁食
ingest 摄取
right lateral decubitus position 右侧卧位
decubitus 褥疮；卧位
supine position 仰卧位
2
知识扩大
非劣效病态测试：一种随机依此临床测试（RCT）。在这种测试中，深入科学界将一种在此之后疗程工具与一种标准的有活病态的疗法（不是与双盲或不顺利进行疗程的依此三组）顺利进行更为，试由此可知证实新疗程工具的不比依此疗法差。当预期一种新解毒与对比解毒有相似有效病态但同时能共享某些比依此解毒优于之处时，可以使用非劣效病态测试。
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