床旁超声测量下腔静脉呼吸变异指数对急性循环障碍机械通气患者容量反应性的评估  

Assessment of Volume Responsiveness in Mechanically Ventilated Patients with Acute Circulatory Disorders by Bedside Ultrasound Measurement of Inferior Vena Cava Respiratory Variability Index

作　　者：刘媛 郑鹏 吴衡[1] LIU Yuan;ZHENG Peng;WU Heng(Department of Emergency Medicine,Yixing People's Hospital,Yixing,Jiangsu Province,214200 China)

机构地区：[1]宜兴市人民医院急诊科,江苏宜兴214200

出　　处：《世界复合医学》2023年第1期25-28,共4页World Journal of Complex Medicine

基　　金：无锡市卫生健康委科研项目(M202056)。

摘　　要：目的 探讨急性循环障碍机械通气患者通过床旁超声测量下腔静脉呼吸不变异指数评估容量反应性的应用价值。方法 选取2020年1月—2021年12月宜兴市人民医院收治的急性循环障碍机械通气患者60例患者为研究对象,均实施补液试验,根据患者容量反应性差异分为观察组(30例,心脏指数增加15%及以上)与对照组(30例,心脏指数增加不足15%)。均进行床旁超声测量,对比两组患者补液前后血流动力学指标变化,分析下腔静脉呼吸变异指数对机械通气患者容量反应性的预测价值。结果 观察组患者补液后下腔静脉最大直径(2.13±0.25)cm、最小直径(1.78±0.14)cm均大于对照组,变异指数(14.12±3.25)%低于对照组,差异有统计学意义(t=3.793、5.050、5.726,P<0.05)。相关性分析结果显示,下腔静脉直径、下腔静脉呼吸变异指数均可有效预测患者容量反应性(P<0.05)。结论 急性循环障碍机械通气患者可利用床旁超声测量下腔静脉呼吸变异指数的方式评估患者容量反应性,属于无损检测方式,为临床提供可靠数据支持。Objective To investigate the application value of volume responsiveness assessed by bedside ultrasound measurement of inferior vena cava respiratory variability index in mechanically ventilated patients with acute circulatory impairment.Methods 60 patients with acute circulatory dysfunction and mechanical ventilation admitted to Yixing People's Hospital from January 2020 to December 2021 were selected as the study subjects,and all of them underwent fluid replacement test.According to the difference in patient volume responsiveness,they were divided into the observation group(30 patients,cardiac index increase by 15% or more) and the control group(30 patients,cardiac index increased by less than 15%).All patients were measured by bedside ultrasound,and the changes of hemodynamic indexes before and after fluid infusion were compared between the two groups,to analyze the predictive value of inferior vena cava respiratory variability index on volume responsiveness in patients with mechanical ventilation.Results The maximum diameter(2.13±0.25) cm and the minimum diameter(1.78±0.14) cm of the inferior vena cava of patients in the observation group were larger than those in the control group after fluid infusion,and the variation index(14.12±3.25)% was lower than that in the control group,the difference was statistically significant(t=3.793,5.050,5.726,P<0.05).The results of correlation analysis showed that the diameter of the inferior vena cava and the respiratory variation index of the inferior vena cava could effectively predict the volume response of patients(P<0.05).Conclusion The measurement of inferior vena cava respiratory variability index by bedside ultrasound can be used to assess the volume responsiveness of patients with acute circulatory disorders with mechanical ventilation,which is a nondestructive test that provides reliable clinical data support.

关 键 词：床旁超声测量 下腔静脉呼吸变异指数 急性循环障碍 机械通气 容量反应 

分 类 号：R687[医药卫生—骨科学]