下腔静脉扩张度与被动抬腿试验关系的相关性研究  

The relationship between inferior vena cava dilatation extent and passive leg raising test

作　　者：王震[1] 史金英[1] 宋宁[1] 柴书坤[1] 王正 金仲群 WANG Zhen;SHI Jinying;SONG Ning(Department of Respiratory Medicine,The First Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050011,China)

机构地区：[1]河北省石家庄市第一医院呼吸内科三病区,050011 [2]河北医科大学第二医院呼吸三科 [3]河北省中医院功能科

出　　处：《河北医药》2018年第18期2774-2777,共4页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题(编号:20150157)

摘　　要：目的评估下腔静脉扩张度与被动抬腿试验(PLRT)的关系。方法肺炎所致脓毒症休克机械通气患者,所有患者依据PLRT的结果,分为PLRT阳性组及PLRT阴性组。比较2组下腔静脉扩张度的差异及其与被动抬腿试验的相关性。结果 PLRT阳性组下腔静脉最大径、下腔静脉最小径小于PLRT阴性组(P<0.05)。2组下腔静脉扩张度差异有统计学意义(P<0.05)。下腔静脉扩张度预测被动抬腿试验阳性的最佳值为19.2%,敏感度96.2%,特异度90.5%,曲线下面积98.5%。结论对于心功能及腹内压正常且无下腔静脉压迫、阻塞的患者,下腔静脉扩张度与被动抬腿试验有着密切的关系,可预测被动抬腿试验阳性的结果,从而替代被动抬腿试验来预测脓毒症患者的容量反应性。Objective To assess the relationship between inferior vena cava（IVC） dilatation extent and passive leg raising test（PLRT）. Methods Septic shock patients with mechanical ventilation caused by pneumonia were enrolled in this study. All patients were divided into PLRT positive group and PLRT negative group according to the results of PLRT. The difference in dilatation degree of IVC and its correlation with PLRT between the two groups were compared. Results The maximum diameter and the minimum diameter of IVC in the PLRT positive group were smaller than those in the PLRT negative group（P〈0. 05）. There was a statistically significant difference in the degree of IVC dilatation between the two groups（P〈0. 05）. The optimal value to predict positive result of PLRT based on IVC dilatation was 19. 2%. Moreover,the sensitivity and specificity were 96. 2% and 90. 5%,respectively,and the area under the curve was 98. 5%. Conclusion For the patients with normal cardiac function and intra-abdominal pressure without compression and obstruction,there is a close correlation between inferior vena cava dilatation extent and passive leg raising test,which can predict the positive result of PLRT. Therefore,it can replace PLRT to predict the volume reactivity of patients with sepsis.

关 键 词：超声 下腔静脉扩张度 脓毒症休克 被动抬腿试验 

分 类 号：R631.4[医药卫生—外科学]