机械通气患者中心静脉压与上腔静脉横径相关性研究  

Correlation between central venous pressure and superior vena cava diameter of the patients undergoing mechanical ventilation

作　　者：林慧艳 李海玲 辛苏宁 吕发勤 顾晓峰 缪文丽 

机构地区：[1]401医院ICU,山东青岛266071 [2]401医院干部病房,山东青岛266071 [3]401医院特检科,山东青岛266071

出　　处：《实用医药杂志》2010年第2期100-102,共3页Practical Journal of Medicine & Pharmacy

摘　　要：目的通过监测机械通气患者中心静脉压(CVP)与上腔静脉横径值(SVCD)的动态变化,评价呼气末正压(PEEP)对机械通气患者CVP与SVCD的影响,以及CVP与SVCD相关性研究,为用无创手段测定机械通气患者SVCD值以来指导患者液体治疗提供理论依据。方法选取22例因急性呼吸衰竭行机械通气的患者应用彩色超声诊断仪监测受试者在不同水平PEEP(0～20cmH2O)时的SVCD值与CVP值,同时记录患者心率、平均动脉压与血氧饱和度,分析SVCD、CVP与PEEP相关性分析。结果①机械通气患者SVCD值随PEEP值的增加而递减,SVCD与PEEP值呈显著负相关(r=-0.981,P<0.01);②CVP与PEEP呈显著正相关(r=0.997,P<0.01);③CVP与SVCD值呈显著负相关(r=-0.961,P<0.01)。结论机械通气时患者SVCD值随PEEP值增加而减少,CVP随PEEP值增加而增加,从而可用多普勒超声心动图检查来监测SVCD值,以间接评价患者治疗效果。Objective To evaluate the effect of positive end-expiratory pressure （PEEP） on central venous pressure（CVP） and superior vena cava diameter（SVCD）of the patients undergoing mechanical ventilation in dynamic diversify, and to find the correlation between CVP and SVCD; To verify the theory of monitoring CVP with non- invasive method. Methed The 22 patients （14 male and 8 female）undergoing mechanical ventilation for acute respiratory failure were enrolled in the study, and SVCD was measured by Doppler ultrasonography. SVCD, CVP, heart rate （HR）, mean arterial pressure （MAP） and oxygen saturation of arterial blood （SaO2） at various PEEP levels were recorded . Data were processed by F test and correlativity analysis. Result 1）There were decreases of SVCD accompanied with PEEP increment,and there was a significant negative correlation between SVCD and PEEP （r=- 0.981, P〈0.01）; 2）There were increases of CVP accompanied with PEEP increment, and there was a significant positive correlation between CVP and PEEP（r=0.997, P〈0.01）; 3）There was a significant negative correlation between CVP and SVCD （r=-0.961, P〈0.01）. Conclusion Monitoring SVCD by Doppler ultrasonography was an effective method directing fluid therapy in patients undergoing mechanical ventilation.

关 键 词：呼气末正压 多谱勒超声检查 上腔静脉横径 中心静脉压 机械通气 

分 类 号：R459.7[医药卫生—急诊医学]