下腔静脉塌陷指数在指导心功能不全患者困难撤机中的应用效果  

Effectiveness of Inferior Vena Cava Collapse Index in Guiding Difficult Withdrawals in Patients with Cardiac Insufficiency

作　　者：张亚娟[1] 丘睿业[1] 肖百芳[1] Zhang Ya-juan;Qiu Rui-ye;Xiao Bai-fang(Department of Intensive Care Medicine,Meizhou People's Hospital,Meizhou 514000,Guangdong Province,China)

机构地区：[1]广东省梅州市人民医院重症医学科,广东梅州514000

出　　处：《中外医药研究》2022年第14期81-83,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:探讨不同数值的下腔静脉塌陷指数(IVC-CI)与心功能不全患者困难撤机的相关性。方法:选取2019年1月-2022年7月梅州市人民医院重症监护室行有创机械通气的心功能不全患者30例为观察对象,按照是否成功撤呼吸机分为成功撤机组(n=26)和困难撤机组(n=4)。入选患者症状好转后进入撤机筛查实验,撤机筛查时进行IVC-CI,比较下腔静脉内径,IVC-CI、平均动脉压(MAP)、氧合指数,IVC-CI对心功能不全患者困难撤机的预测价值。结果:成功撤机组IVC-CI高于困难撤机组,差异有统计学意义(P<0.05);IVC-CI在预测心功能不全患者困难撤呼吸机的ROC曲线下面积=0.894,95%CI=0.778~1.000,P=0.012,IVC-CI所对应的Youden指数为0.885时,特异度为1.000,敏感度0.885,IVC-CI为0.124。结论:IVC-CI值对心功能不全患者撤呼吸机的预测较传统撤机指标更有优势,及时监测IVCCI值可为心功能不全患者撤呼吸机提供参考。Objective:To investigate the correlation between different values of inferior vena cava collapse index(IVC-CI)and difficult withdrawals in patients with cardiac insufficiency.Methods:Thirty patients with cardiac insufficiency who underwent invasive mechanical ventilation in the intensive care unit of Meizhou People's Hospital from January 2019 to July 2022 were selected as observation subjects.They were divided into successful withdrawal group(n=26)and difficult withdrawal group(n=4)according to whether the ventilator was successfully withdrawn or not.The patients were enrolled in the withdrawal screening trial after their symptoms improved.IVC-CI was performed at the time of withdrawal screening.The predictive value of inferior vena cava internal diameter,IVC-CI,mean arterial pressure(MAP),and oxygenation index for difficult withdrawals in patients with cardiac insufficiency was compared.Results:IVC-CI was higher in the successful withdrawal group than in the difficult withdrawal group,and the difference was statistically significant(P<0.05).Area under the ROC curve of IVC-CI in predicting difficult ventilator withdrawal in patients with cardiac insufficiency=0.894,95%CI=0.778~1.000,P=0.012.When the Youden index corresponding to IVC-CI was 0.885,the specificity was 1.000,the sensitivity was 0.885 and the IVC-CI was 0.124.Conclusion:The IVC-CI values are more advantageous than traditional withdrawal indicators for predicting ventilatory withdrawal in patients with cardiac insufficiency,and timely monitoring of the IVC-CI values can provide a reference for ventilatory withdrawal in patients with cardiac insufficiency.

关 键 词：下腔静脉塌陷指数 心功能不全 机械通气 ROC曲线 

分 类 号：R54[医药卫生—心血管疾病]