能量多普勒超声在围术期重症妊娠期高血压疾病患者急性肾损伤早期诊断的应用研究

发布时间：2019-03-21 20:08

【摘要】：目的探讨能量多普勒超声(PDU)半定量评分在围术期重症妊娠期高血压患者急性肾损伤(AKI)早期诊断中的应用价值。方法选择围术期重度妊娠期高血压孕产妇患者60例作为研究对象,连续监测在进入重症监护病房(ICU)后的0、6、12、18和24 h使用超声测量患者的肾脏阻力指数(RI)、PDU半定量得分等血流动力学参数以及BUN、Cr等指标,根据患者进入ICU 72 h后的临床表现分为AKI组和非AKI组,比较两组患者在入室第1天0、6、12、18、24 h的RI以及上述时间段内PDU的平均值与AKI发生的相关关系。结果 AKI组患者在24 h内尿素氮(BUN)和肌酐(Cr)指标变化不明显,但是RI和PDU却有统计学差异(P0.05),并且RI与平均PDU之间有负相关关系(|r|0.70);12、18和24 h内PDU平均得分的ROC曲线下面积(AUC)分别为0.836、0.880和0.894,切入点分别为2.17、2.13和2.30。结论围手术期重度妊娠期高血压孕产妇在AKI发生之前,RI和PDU等血流动力学参数会发生明显变化,进入ICU后12 h的平均PDU得分低于2可以作为AKI早期诊断的依据。
[Abstract]:Objective to evaluate the value of power Doppler (PDU) semi-quantitative score in the early diagnosis of acute renal injury (AKI) in patients with severe pregnancy-induced hypertension (hypertensive complicating pregnancy). Methods the renal resistance index (RI),) of 60 pregnant women with severe pregnancy hypertension during peri-operative period was measured by ultrasound at 0,6,12,18 and 24 hours after entering the intensive care unit (ICU), and the renal resistance index (RI),) of the patients was measured continuously at 0,6,12,18 and 24 hours after admission to the intensive care unit. The hemodynamic parameters such as PDU semi-quantitative score and BUN,Cr were divided into AKI group and non-AKI group according to their clinical manifestations 72 hours after entering ICU, and the two groups were compared at 0, 6, 6 on the 1st day of entering the room, and the other two groups were divided into AKI group and non-AKI group. RI at 12,18,24 hours and the correlation between the mean value of PDU and the occurrence of AKI. Results there was no significant change in urea nitrogen (BUN) and creatinine (Cr) in AKI group within 24 hours, but there was significant difference in RI and PDU (P0.05), and there was a negative correlation between RI and average PDU (| r | 0.70). The area (AUC) under the ROC curve was 0.836, 0.880 and 0.894, respectively, and the entry point was 2.17,2.13 and 2.30, respectively. The mean score of PDU within 18 and 24 hours was 0.836, 0.880 and 0.894, respectively. Conclusion the hemodynamic parameters such as RI and PDU will change obviously before the occurrence of AKI in the pregnant women with severe pregnancy hypertension during perioperative period. The average PDU score of 12 hours after entering ICU can be used as the basis for early diagnosis of AKI. [WT5 "HZ] conclusion [WT5" BZ]
【作者单位】：承德市中心医院妇产科;承德市中心医院超声诊断科;承德市中心医院重症医学科;承德市中心医院肿瘤外科;
【分类号】：R714.246

【参考文献】