超声检测下腔静脉和锁骨下静脉内径变异在预测全身麻醉诱导后低血压中的价值  

Values of Ultrasound Detection of Variations in the Inner Diameter of the Inferior Vena Cava and Subclavian Vein in Predicting Post-induction Hypotension in General Anesthesia

作　　者：刘乐 艾麟 LIU Le;AI Lin(Ultrasound Inferior vena cava Subclavian vein Inner diameter variation Collapsibility index General anesthesia Post-induction hypotension;不详)

机构地区：[1]咸宁市第一人民医院超声科,湖北咸宁437000 [2]咸宁市第一人民医院麻醉科,湖北咸宁437000

出　　处：《中国医学创新》2024年第13期134-138,共5页Medical Innovation of China

摘　　要：目的:分析超声检测下腔静脉(IVC)和锁骨下静脉(SCV)内径变异在预测全麻诱导后低血压(PIH)中的价值。方法:回顾性选取2021年5月—2023年5月在咸宁市第一人民医院行全麻手术的204例患者作为研究对象,根据是否发生PIH将其分为研究组(发生PIH,86例)和对照组(未发生PIH,118例)。对两组患者的基础资料、麻醉诱导前血压、麻醉诱导药物用量进行对比。比较IVC内径的最大值(IVCmax)和最小值(IVCmin)、SCV内径的最大值(SCVmax)和最小值(SCVmin),并计算IVC塌陷指数(IVCCI)和SCV塌陷指数(SCVCI)。采用受试者工作特征(ROC)曲线分析IVC、SCV内径及变异对全麻PIH的预测价值。结果:两组基础资料、麻醉诱导前血压指标和麻醉诱导药物用量比较,差异均无统计学意义(P>0.05)。研究组IVCmax、IVCmin、SCVmax、SCVmin水平均低于对照组,IVCCI、SCVCI水平均高于对照组,差异均有统计学意义(P<0.05)。受试者操作特征(ROC)曲线分析结果显示,麻醉诱导前IVCmax、IVCmin、SCVmax、SCVmin、IVCCI、SCVCI水平预测PIH的ROC曲线下面积(area under curve,AUC)分别为0.674、0.675、0.618、0.707、0.895、0.905,其中,SCVCI的AUC和cut-off值下的敏感度均为最高,分别为0.905、65.12%。结论:全麻PIH患者可表现为IVC和SCV内径缩小及IVCCI、SCVCI等内径变异指标的增高,采用血管超声技术检测上述变异指标可辅助预测PIH风险。Objective:To analyze the values of ultrasound detection of variations in the diameter of inferior vena cava(IVC)and subclavian vein(SCV)in predicting post-induction hypotension(PIH)in general anesthesia.Method:A total of 204 patients who underwent general anesthesia surgery in Xianning First People's Hospital from May 2021 to May 2023 were selected as the study subjects retrospectively,they were divided into a study group(86 patients with PIH)and a control group(118 patients without PIH)based on whether they had PIH.The basic data,the blood pressure indexes before anesthesia induction and the dosage of anesthesia induction drugs between the patients in the two groups were compared.Maximum value of IVC inner diameter(IVCmax)and minimum value(IVCmin),maximum value of SVC inner diameter(SCVmax)and minimum value(SCVmin)were compared,the collapsibility index of IVC(IVCCI)and the collapsibility index of SCV(SCVCI)were calculated.The predictive values of IVC,SCV inner diameter and variation on general anesthesia PIH were analyzed by receiver operating characteristic(ROC)curves.Result:There were no statistically significant differences in the basic data,blood pressure indexes before anesthesia induction,and the dosage of anesthesia induction drugs between the patients in the two groups(P>0.05).The levels of IVCmax,IVCmin,SCVmax,and SCVmin of the patients in the study group were lower than those in the control group,while the levels of IVCCI and SCVCI were higher than those in the control group,the differences were statistically significant(P<0.05).The ROC curve analysis results showed that the ROC areas under curve(AUC)of PIH predicted by the levels of IVCmax,IVCmin,SCVmax,SCVmin,IVCCI,and SCVCI before anesthesia induction were 0.674,0.675,0.618,0.707,0.895,and 0.905,respectively(P<0.05).AUC,the sensitivity under cut-off value of SCVCI were the highest,which was 0.905,65.12%respectively.Conclusion:The patients with PIH in general anesthesia can exhibit reduced inner diameter of IVC and SCV,as well as increased inner diam

关 键 词：超声 下腔静脉 锁骨下静脉 内径变异 塌陷指数 全麻 诱导后低血压 

分 类 号：R614.2[医药卫生—麻醉学]