超声参数预测剖宫产术中仰卧位低血压综合征风险的价值  

Value of ultrasound parameters in predicting the risk of supine hypotension syndrome during cesarean section

作　　者：张峰[1] 董茜[1] Zhang Feng;Dong Qian(Ultrasonography department,medical and health group of Yongcheng people's hospital,Yongcheng,Henan,476600,China)

机构地区：[1]永城市人民医院医疗健康集团超声科,河南永城476600

出　　处：《齐齐哈尔医学院学报》2021年第19期1704-1707,共4页Journal of Qiqihar Medical University

摘　　要：目的研究超声参数预测剖宫产术中仰卧位低血压综合征(SHS)风险的价值。方法选择2019年3—12月本院收治的84例择期拟行腰椎麻醉下剖宫产手术的产妇作为研究对象,根据术中是否发生SHS将产妇分为SHS组(36例)和非SHS组(48例),记录两组麻醉前分别于仰卧位和侧卧位下心率(HR)及平均动脉血压(MAP),并行超声检查检测两种体位下呼气末下腔静脉最大径(IVCe)和吸气末最小径(IVCi),计算下腔静脉塌陷指数(IVCCI),测量呼气相初期肱动脉峰流速最大值(Vpmax)及最小值(Vpmin),分别计算并比较两组上述指标在两种体位下的差值(△)。结果两组不同体位IVCi、Vpmax、Vpmin存在显著差异(P<0.05),SHS组不同体位IVCe、IVCCI存在显著差异(P<0.05)。SHS组△IVCe、△IVCCI、△Vpmin均显著高于非SHS组(P<0.05)。经ROC曲线分析显示△IVCe、△IVCCI、△Vpmin对剖宫产术中SHS风险均有一定预测价值。结论超声参数△IVCe、△IVCCI、△Vpmin对预测剖宫产术中SHS风险具有重要临床价值。Objective Ultrasonography department,medical and health group of Yongcheng people's hospital,Yongcheng,Henan,476600,China Methods 84 pregnant women who planned to undergo cesarean section under lumbar anesthesia were included as the research objects,according to the occurrence of SHS during the operation,the pregnant women were divided into SHS group(36 cases)and non SHS group(48 cases).Heart rate(HR)and mean arterial blood pressure(MAP)were recorded in supine position and lateral position before anesthesia.The maximum diameter of end expiratory inferior vena cava(IVCe)and minimum diameter of end expiratory inferior vena cava(IVCi)were measured by ultrasonography.The inferior vena cava collapse index(IVCCI)was calculated,and the peak velocity of brachial artery(Vpmax)and minimum(Vpmin)were measured at the beginning of expiratory phase.The differences(△)of the above indexes between the two groups in two postures were calculated and compared.Results There were significant differences in IVCi,Vpmax and Vpmin in different postures between the two groups(P<0.05).There were significant differences in IVCe and IVCCIbetween different postures in SHS group(P<0.05).The△IVCe,△IVCCI and△Vpmin in SHS group were significantly higher than those in non SHS group(P<0.05).ROC curve analysis showed that△IVCe,△IVCCI and△Vpmin had certain predictive value for the risk of SHS during cesarean section.Conclusions The ultrasound parameters△IVCe,△IVCCI and△Vpmin had important clinical value in predicting the risk of SHS during cesarean section.

关 键 词：剖宫产术 仰卧位低血压综合征 下腔静脉 塌陷指数 

分 类 号：R719[医药卫生—妇产科学]