超声测量下腔静脉内径呼吸变异度对重症监护室脓毒性休克患者容量反应的评估价值  

Evaluation Value of Respiratory Variability of Inferior Vena Cava Diameter Measured by Ultrasound on Volume Response in Patients with Septic Shock in ICU

作　　者：刘招杰 LIU Zhao-jie(Intensive Care Medicine,Quanzhou First Hospital,Fujian Medical University,Fujian Quanzhou 362000)

机构地区：[1]福建医科大学附属泉州市第一医院重症医学科,福建泉州362000

出　　处：《中国医疗器械信息》2024年第11期97-99,共3页China Medical Device Information

摘　　要：目的:探讨超声测量下腔静脉内径呼吸变异度(RVI)对重症监护室(ICU)脓毒性休克患者容量反应的评估价值。方法:选取2021年3月~2023年3月在本院ICU接受治疗的60例脓毒性休克患者。所有患者均行容量负荷试验,依据试验结果分为阳性组与阴性组。所有患者均接受超声检查,比较两组试验前后D_(max)、D_(min)、RVI、中心静脉压、心脏指数(CI)。运用受试者工作特征曲线评估D_(max)、D_(min)、RVI对容量反应阳性的预测价值。结果:所有患者均行容量负荷试验,结果显示容量反应阳性32例,设为阳性组,容量反应阴性28例,设为阴性组。试验前,阳性组D_(max)、D_(min)均低于阴性组,RVI高于阴性组,差异具有统计学意义(P<0.05);试验后,阳性组CI高于阴性组,差异具有统计学意义(P<0.05)。D_(max)、D_(min)、RVI对容量反应性预测价值的曲线下面积分别为0.936、0.860、0.954。结论:RVI可作为预测ICU脓毒性休克患者容量反应临床手段之一,为临床后续治疗提供参考。Objective:To explore the value of respiratory variability(RVI)of inferior vena cava diameter measured by ultrasound in evaluating the volume response of patients with septic shock in the intensive care unit(ICU).Methods:60 patients with septic shock who received treatment in our hospital’s ICU from March 2021 to March 2023 were selected.All patients underwent volume load testing and were divided into positive and negative groups based on the test results.All patients underwent ultrasound examination,and D_(max),D_(min),RVI,central venous pressure,and cardiac index(CI)were compared between the two groups before and after the experiment.Evaluate the predictive value of D_(max),D_(min),and RVI for volume response positivity using subject working characteristic curves.Results:All patients underwent volume load test,and the results showed that 32 cases had a positive volume response,which was designated as a positive group.28 cases had a negative volume response,which was designated as a negative group.Before the experiment,Dmax and Dmin in the positive group were lower than those in the negative group,while RVI was higher than that in the negative group,with a statistically significant difference(P<0.05);After the experiment,the CI of the positive group was higher than that of the negative group,and the difference was statistically significant(P<0.05).The area under the curve of the predictive value of D_(max),D_(min),and RVI for volume reactivity is 0.936,0.860,and 0.954,respectively.Conclusion:RVI can be used as one of the clinical means to predict volume response in ICU septic shock patients,providing reference for subsequent clinical treatment.

关 键 词：超声 下腔静脉内径呼吸变异度 脓毒性休克 容量反应 预测价值 

分 类 号：R631.4[医药卫生—外科学]