机械通气脓毒症休克患者下腔静脉管径/呼吸变异指数与中心静脉压的关系  

Correlation between inferior vena cava diameter/respiration variation index and central venous pressure in mechanical ventilated patients with septic shock

作　　者：彭绵[1] 方伟强[2] 蔡举瑜[2] 吕丽燕[1] 

机构地区：[1]深圳市第五人民医院,广东518005 [2]汕头大学医学院第一附属医院

出　　处：《内科急危重症杂志》2015年第5期333-335,共3页Journal of Critical Care In Internal Medicine

摘　　要：目的:探讨机械通气脓毒症休克患者下腔静脉管径/呼吸变异指数与中心静脉压的关系。方法:选择机械通气脓毒症休克患者97例为脓毒症休克组,另选择脓毒症休克已达复苏目标的患者93例作为对照组。分别于液体复苏前、液体复苏2、6 h测量中心静脉压、下腔静脉最大径-下腔静脉最小径,计算下腔静脉呼吸变异指数[(下腔静脉最大径-下腔静脉最小径)/下腔静脉最大径×100%],分析下腔静脉最大径、下腔静脉最小径、下腔静脉呼吸变异指数与中心静脉压的相关性。结果:机械通气脓毒症休克患者下腔静脉管径显著小于对照组(P<0.05),下腔静脉呼吸变异指数显著大于对照组(53.63%±10.58%vs 12.75%±1.67%,P=0.017);在液体复苏过程中,下腔静脉最大径、下腔静脉最小径、下腔静脉呼吸变异指数与中心静脉压均有明显的相关性(r分别为0.841、0.897、-0.812,均P<0.01)。结论:对于机械通气脓毒症休克患者,下腔静脉管径/呼吸变异指数与中心静脉压具有很好的相关性,床边超声检测下腔静脉管径,有助于无创、快速、动态判断患者的容量反应性。Objective： To explore the correlation between inferior vena cava（ IVC） diameter / respiration variation index（ RVI） and central venous pressure（ CVP） in mechanical ventilated patients with septic shock. Methods： A total of 97 mechanical ventilated cases with septic shock were included in this study as intervention group,another 93 cases of septic shock patients who had achieved resuscitation goal were as the control group. CVP,the maximum of inferior vena diameter（ IVCmax）,the minimum of inferior vena diameter（ IVCmin） and the RVI [（ IVCmax- IVCmin） / IVCmax × 100%] were measured,calculated and recorded before and at 2 hours and 6 hours of fluid resuscitation,and the correlation between IVCmax,IVCmin,RVI and CVP was analyzed. Results： The IVC diameter is much smaller in the ventilated septic shock group than that in the control group（ P〈0. 05）,and the RVI of IVC is much larger in the ventilated septic shock group when compared with those of control group（ 53. 63 ± 10. 58% vs 12. 75 ± 1. 67%,P = 0. 017）. During the fluid resuscitation,the IVCmax,IVCmin and RVI were all significantly correlated with CVP（ r = 0. 841,r = 0. 897,r =- 0. 812,P〈0. 01）. Conclusions： For mechanically ventilated patients with septic shock,the IVC diameter / RVI correlates well with CVP,bedside ultrasound can provide us a noninvasive,fast,dynamic method to evaluate patients＇ fluid responsibility.

关 键 词：下腔静脉管径 呼吸变异指数 中心静脉压 

分 类 号：R515.3[医药卫生—内科学]