彭绵.机械通气脓毒症休克患者下腔静脉管径/呼吸变异指数与中心静脉压的关系[J].内科急危重症杂志,2015,21(5):
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| DOI： |
| 中文关键词: 下腔静脉管径 呼吸变异指数 中心静脉压 |
| 英文关键词:Inferior vena cava diameter, Respiration variation index, Central venous pressure |
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| 中文摘要: |
| 目的 探讨机械通气脓毒症休克患者下腔静脉管径/呼吸变异指数与中心静脉压的关系。方法 采用前瞻性随机对照的研究方法, 选择2011年1月～2014年12月在我院及汕头大学医学院第一附属医院重症医学科住院的机械通气脓毒症休克患者97例作为研究对象,另选择脓毒症已达复苏目标的患者93例作为对照组。分别于液体复苏前、液体复苏2小时、液体复苏6小时测量中心静脉压、下腔静脉最大径、下腔静脉最小径,计算下腔静脉呼吸变异指数[(下腔静脉最大径－下腔静脉最小径)/ 下腔静脉最大径 ×100%],分析下腔静脉最大径、下腔静脉最小径、下腔静脉呼吸变异指数与中心静脉压的相关性。 结果 机械通气脓毒症休克患者下腔静脉管径显著小于对照组(下腔静脉最大径:1.10 ± 0.18 cm vs. 2.10 ± 0.40 cm, P=0.023; 下腔静脉最小径: 0.50 ± 0.09 cm vs. 1.83 ± 0.36 cm, P=0.003),下腔静脉呼吸变异指数显著大于对照组(53.63 ± 10.58% vs. 12.75 ± 1.67%, P=0.017)；在液体复苏过程中,下腔静脉最大径、下腔静脉最小径、下腔静脉呼吸变异指数与中心静脉压均有明显的相关性(下腔静脉最大径 中心静脉压: r=0.841, P=0.000; 下腔静脉最小径 中心静脉压: r=0.897, P=0.000; 下腔静脉呼吸变异指数 中心静脉压: r=–0.812, P=0.000)。结论 对于机械通气脓毒症休克患者,下腔静脉管径/呼吸变异指数与中心静脉压具有很好的相关性,床边超声检测下腔静脉管径,有助于无创、快速、动态判断患者的容量状态。 |
| 英文摘要: |
| Objective To explore the correlation between inferior vena cava(IVC) diameter/respiration variation index(RVI) and central venous pressure(CVP) in mechanical ventilated patients with septic shock. Methods A total of 97 cases of mechanically ventilated patients with septic shock were included in this prospective randomized controlled study into the intervening group, another 93 cases of patients who have reached resuscitation goal were included into the control group. The patients were collected from our hospital and the First Affiliated Hospital of Shantou University Medical College from January 2011 to December 2014. For each group, the CVP, the maximun of inferior vena diameter(IVCmax) , the minimum of inferior vena diameter(IVCmin) and the RVI [(IVCmax－IVCmin)/ IVCmax ×100%]were measured, and recorded before and at 2h and 6h of fluid resuscitation, and the correlation between IVCmax, IVCmin, RVI and CVP was analysed. Results The IVC diameter is much smalled in the ventilated septic shock group than in the control group (IVCmax:1.10 ± 0.18 cm vs. 2.10 ± 0.40 cm, P=0.023; IVCmin: 0.50 ± 0.09 cm vs. 1.83 ± 0.36 cm, P=0.003), and the RVI of IVC is much larger in the ventilated septic shock group when compared with the control group(53.63 ± 10.58% vs. 12.75 ± 1.67%, P=0.017). During the fluid resuscitation, the IVCmax, IVCmin and RVI were all significantly correlated with CVP (IVCmax & CVP: r=0.841, P=0.000; IVCmin |
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