超声法测量下腔静脉直径用于评估老年患者术前血容量的准确性  

Accuracy of ultrasound-measured inferior vena cava diameter in assessment of preoperative blood volume in elderly patients

作　　者：赵志斌[1] 朱品[1] 冯继英[1] 栾恒飞[1] 崔吉正[1] 张小宝[1] 

机构地区：[1]连云港市第一人民医院麻醉科,222000

出　　处：《中华麻醉学杂志》2015年第1期91-94,共4页Chinese Journal of Anesthesiology

基　　金：连云港市卫生局课题资助（1401）

摘　　要：目的 评价超声法测量下腔静脉（IVC）直径用于评估老年患者术前血容量的准确性.方法 择期拟行前列腺电切术患者60例,年龄60 ～ 75岁,体重指数20～25 kg/m^2,ASA分级Ⅰ-Ⅲ级,采用随机数字表法分为3组（n=20）：对照组（C组）、乳酸钠林格氏液组（RL组）和羟乙基淀粉组（H组）.C组不给予任何液体;RL组静脉输注乳酸钠林格氏液8 ml/kg;H组静脉输注6％羟乙基淀粉130/0.4 8 ml/kg.于液体治疗前（T1）和治疗后（T2）记录SpO2 MAP、HR和CVP,超声引导下测量IVC的最大直径（IVCe）和最小直径（IVCi）,计算下腔静脉呼吸衰减指数（IVC-CI）.结果 与T1时比较,RL组和H组T2时IVCe、IVCi增加,IVC-CI降低（P＜0.05）.与C组比较,RL组和H组T2时IVCe、IVCi增加,IVC-CI降低（P＜0.05）.IVCe及IVCi与CVP呈正相关（r分别为0.746、0.697,P＜0.01）;IVC-CI与CVP呈负相关（r=-0.547,P＜0.01）.结论 超声法测量IVC直径用于评估老年患者术前血容量的准确性较好.Objective To evaluate the accuracy of ultrasound-measured inferior vena cava （IVC） diameter in assessment of the preoperative blood volume in elderly patients.Methods Sixty patients,aged 60-75 yr,with body mass index 20-25 kg/m^2,of ASA physical status Ⅰ-Ⅲ,scheduled for elective transurethral resection of prostate,were randomly divided into 3 groups （n =20 each）：control group （group C）,lactated Ringer＇s solution group （group RL）,and hydroxyethyl starch group （group H）.Lactated Ringer＇s solution 8 ml/kg was infused intravenously in group RL.Hydroxyethyl starch 130/0.4 8 ml/kg was infused intravenously in group H.SpO2,mean arterial pressure （MAP）,HR and central venous pressure （CVP） were monitored before and after fluid therapy.The IVC diameters,both during expiration （IVCe） and inspiration （IVCi）,were measured using ultrasound.IVC collapsibility index （IVC-CI） was calculated.Results The IVCeand IVCi were significantly increased,and IVC-CI was decreased after fluid therapy as compared with those before fluid therapy in RL and H groups.Compared with group C,the IVCe and IVCi were significantly increased,and IVC-CI was decreased after fluid therapy in RL and H groups.IVCe and IVCi were positively correlatedwith CVP （r=0.746 and 0.697,respectively）.IVC-CI was negatively correlated with CVP （r =-0.547）.Conclusion Ultrasoundmeasured IVC diameter provides better accuracy in assessing the preoperative blood volume in elderly patients.

关 键 词：超声检查 腔静脉 下 老年人 血管容量 手术前期 

分 类 号：R614[医药卫生—麻醉学]