血液透析患者下腔静脉直径/体表面积变化及意义  

Changes and significance of inferior vena cava diameter/body surface area in patients under treatment of hemodialysis

作　　者：毛艳卿 喻晓东 李扬麟 蒋东培 秦漓漓 

机构地区：[1]桂林市第二人民医院,广西桂林541000

出　　处：《山东医药》2014年第3期20-22,共3页Shandong Medical Journal

基　　金：广西壮族自治区卫生厅自筹经费科研课题(22012371)

摘　　要：目的观察血液透析患者下腔静脉直径/体表面积(VCD)变化并探讨其意义。方法选择89例血液透析患者(透析组),于透析前及透析后1 h采用飞利浦彩色多普勒超声测量下腔静脉直径,计算VCD;另选择与透析组相匹配的89例体检正常者为对照组,比较两组VCD。测量超滤量≥2.5 kg及<2.5 kg透析前后VCD。采用Cox回归分析法对VCD与超滤量的关系行相关性分析。结果透析组透析前及透析后1 h的VCD分别为(9.92±0.99)、(9.01±1.43)mm/m2,透析前后比较,P<0.05;对照组VCD为(8.88±1.29)mm/m2,与透析组透析前比较,P<0.05。超滤量≥2.5 kg者透析前后VCD分别为(9.93±1.78)、(8.90±1.31)mm/m2,透析前后比较P<0.05;超滤量<2.5 kg者透析前后VCD分别为(9.30±1.21)、(9.02±1.10)mm/m2,透析前后比较P>0.05。超滤量≥2.5 kg时超滤量与VCD呈负相关(r=-0.928,P<0.05)。结论血液透析患者透析后VCD明显降低;超滤量≥2.5 kg时VCD与超滤量呈负相关;VCD能初步判定患者体液处于平衡状态时的体质量,可作为超滤量≥2.5 kg时血液透析量的调节指标。Objective To observe the changes and significance of inferior vena cava diameter/body surface area （VCD） in patients under treatment of hemodialysis. Methods Eighty-night patients under hemodialysis were selected as the hemodialy- sis group, meanwhile, another 89 healthy people were selected as the control group. We measured their inferior vena cava diame- ter before and 1 h after dialysis by using color Doppler ultrasound, and calculated and compared the VCD between the two groups. The VCD was measured before and after dialysis （ultrafiltration volume≥2.5 kg or 〈2.5 kg）. Cox regression analysis was used to analyze relationship between V CD and ultrafiltration volume. Results The V CD was （9. 92 ± 0. 99）mm/m^2 before dialysis and was approximately （9.01 ±1.43） mm/m^2 1 h after dialysis in the hemodialysis group （P 〈0.05）. VCD value in the control group was（8.88 ± 1.29）mm/m^2. When patients with ultrafiltration volume t〉2. 5 kg, the VCD before and after hemodial- ysis were separately （9.93 ±1.78） and （8.90 ± 1.31 ） mm/rn2 （P 〈 0. 05 ） ; When patients with ultrafihration volume 〈 2. 5 kg, the VCD before and after hemodialysis were separately （9.30 ± 1.21 ） and （9.02 ± 1.10） mm/m^2（ P 〉 0. 05 ）. The ultrafihration volume （ ≥2.5 kg） was negatively correlated with the VCD （r = -0.928, P 〈0.05）. Conclusions The VCD is Significantly lower in patients after hemodialysis, and the ultrafiltration volume （ I〉2.5 kg） is negatively correlated with the VCD. VCD may initially determine the body mass of patients in the equilibrium state, and can also be used as regulating index when the ultrafil- tration volume is greater than or equal to 2.5 kg during the hemodialysis.

关 键 词：肾功能衰竭 血液透析 下腔静脉直径 超滤量 

分 类 号：R692.5[医药卫生—泌尿科学] R459.5[医药卫生—外科学]