床旁超声测量下腔静脉内径变异度在中央性前置胎盘围术期容量评估中的临床应用  

Clinical Application of Bedside Ultrasound Measurement of Inner Diameter Variation of Interior Vena Cava in Perioperative Volume Assessment of Central Placenta Previa

作　　者：徐小强 何春梅 徐迎春 聂去燕 朱俊南 曾玲 XU Xiao-qiang;HE Chun-mei;XU Ying-chun;NIE Qu-yan;ZHU Jun-nan;ZENG Ling(Department of Critical Maternal Treatment Center,He yuan Women and Children's Hospital and Health Institute,Heyuan,Guangdong,Province,517000)

机构地区：[1]广东省河源市妇幼保健院危重孕产妇救治中心,517000

出　　处：《岭南急诊医学杂志》2021年第5期514-516,共3页Lingnan Journal of Emergency Medicine

基　　金：广东省河源市社会发展科技计划项目(201937)。

摘　　要：目的:探讨下腔静脉变异度在中央性前置胎盘孕妇围术期容量评估中的临床应用价值。方法:以2019年7月至2020年12月危重孕产妇救治中心经超声诊断为中央性前置胎盘孕妇60例为研究对象,术前常规行右颈内静脉置管并测中心静脉压(CVP),根据CVP高低分为Ⅰ组(CVP<5 cmH_(2)O)、Ⅱ组(5 cmH_(2)O≤CVP≤12 cmH_(2)O)、Ⅲ组(CVP>12 cmH_(2)O),术前、术后补液500 ml和1000 m时分别测CVP、平均血压(MAP),床旁超声测量下腔静脉最大内径(Dmax)及最小内径(Dmin)及其呼吸变异度(RIVC),并比较其变化。结果:与Ⅰ组相比,Ⅱ组、Ⅲ组的Dmax、Dmin较有明显的提高趋势,而RIVC呈明显下降,P均<0.05;Ⅲ组的Dmax、Dmin比Ⅱ组明显提高,RIVC显著下降,P均<0.05;输液500 ml、1000 ml后Dmax、Dmin、RIVC、MAP、CVP较扩容治疗前均明显改善,P均<0.05。结论:床旁超声测量RIVC能够准确评估中央性前置胎盘患者围术期容量状态。Objective:To explore the clinical value of inferior vena cava variant in the evaluation of perioperative volume assessmen of central placenta previa pregnant women. Methods:60 pregnant women with central placenta previa from Jul 2019 to Dec 2020 diagnosed by ultrasound were researched,and the central venous pressure(CVP)were measured by routine right internal jugular vein tube at preoperative. According to CVP,they were divided into group Ⅰ(CVP<5 cmH;O)、group Ⅱ(5 cmH;=O≤CVP≤12 cmH;O)and group Ⅲ(CVP>12 cmH;O). The CVP and zMAP,the maximum internal diameter(Dmax),the minimum internal diameter(Dmin)and calculates its respiratory variation of interior vena cava(RIVC)measured by bedside ultrasound machine were compared at preoperative,500 ml and 1000 ml rehydration after operation among the three groups. Results:Compared with groupⅠ,the Dmax、Dmin in group Ⅱ and group Ⅲ increased significantly,the RIVC significantly decreased,all P<0.05. Compared with groupⅡ,the Dmax、Dmin in groupⅢ was significantly improved,the RIVC dropped significantly,all P<0.05. The Dmax、Dmin、RIVC、MAP and CVP after 500 ml and 1000 ml infusion was significantly improved compared with before volume therapy,all P<0.05.Conclusion:A bedside ultrasound was used to measure the RIVC can assess volume accurately in patients with central placenta previa during the perioperative period.

关 键 词：床旁超声测量 下腔静脉 内径变异度 中央性前置胎盘 围术期 容量评估 

分 类 号：R719[医药卫生—妇产科学] R445.1[医药卫生—临床医学]