超声下探讨老年患者下腔静脉管径与中心静脉压的相关性
发布时间：2019-02-27 08:39
【摘要】：目的探讨老年患者下腔静脉管径(inferior vena cava diameter,IVCD)与中心静脉压(central venous pressure,CVP)的关系,为床边快速有效且无创地评估老年患者的容量状态提供参考。方法选取2014年5月至2015年2月苏州大学附属第一医院中心ICU病房(surgical intensive care unit,SICU)收治的老年患者35例为研究对象,于右颈内静脉置入中心静脉导管后于1小时内滴入乳酸林格氏液6ml/Kg,于液体治疗前、液体治疗后床边超声测量肝后下腔静脉最大径(inferior vena cava maximum diameter,IVCmax)和下腔静脉最小径(inferior vena cava minimum diameter,IVCmin),同时用水柱法测量CVP。采用配对样本t检验比较液体治疗前后IVCD及CVP的变化;采用Pearson相关性分析了解IVCD与CVP的相关性;绘制受试者工作特征曲线(receive operating characteristic,ROC)确定IVCD预测CVP 5 cm H2O的最佳临界值。结果1.老年患者液体治疗前IVCmax、IVCmin、CVP分别为(1.26±0.30)cm、(0.42±0.21)cm、(6.06±2.14)cm H2O,液体治疗后IVCmax、IVCmin、CVP分别为(1.48±0.25)cm、(0.68±0.19)cm、(7.81±1.85)cm H2O,液体治疗前后IVCmax、IVCmin及CVP均有显著性差异(P0.05)。2.老年患者IVCmax、IVCmin与同期CVP呈正相关(r=0.678、r=0.891,均P0.01),并计算出线性回归方程CVP=5.20 IVCmax 0.25和CVP=8.61 IVCmin+2.14。3.老年患者IVCDmax、IVCDmin预测CVP 5 cm H2O的界值分别为1.53 cm(敏感度64%,特异度76%)、0.69 cm(敏感度80%,特异度88%)。结论1.IVCmax、IVCmin可以早期、及时、准确地预测老年患者的血容量。2.与IVCmax相比,IVCmin对老年患者的血容量的预测效能更好。
[Abstract]:Objective to investigate the relationship between the diameter of inferior vena cava (inferior vena cava diameter,IVCD) and central venous pressure (central venous pressure,CVP) in elderly patients, so as to provide a reference for rapid, effective and non-invasive assessment of the volume status of elderly patients by bedside. Methods from May 2014 to February 2015, 35 elderly patients who were admitted to the ICU ward of the first affiliated Hospital of Suzhou University from May 2014 to February 2015 were enrolled in the study. The central venous catheter was inserted into the right internal jugular vein within 1 hour. The maximum diameter of the posterior inferior hepatic vena cava (inferior vena cava maximum diameter,) was measured by bedside ultrasound before and after the liquid treatment. IVCmax) and the minimum diameter of inferior vena cava (inferior vena cava minimum diameter,IVCmin), and CVP. was measured by water column method at the same time. The changes of IVCD and CVP before and after liquid therapy were compared by paired sample t test, the correlation between IVCD and CVP was analyzed by Pearson correlation analysis, and the optimal critical value of IVCD to predict CVP 5 cm H2O was determined by drawing the receiver operating characteristic curve (receive operating characteristic,ROC). Outcome 1. The IVCmax,IVCmin,CVP before and after liquid therapy were (1.26 卤0.30) cm, (0.42 卤0.21) cm, (6.06 卤2.14) cm H 2O and (1.48 卤0.25) cm, (0.68 卤0.19) cm, respectively. (7.81 卤1.85) cm H 2O, IVCmax,IVCmin and CVP were significantly different before and after liquid therapy (P0.05). There was a positive correlation between IVCmax,IVCmin and CVP in elderly patients (r = 0.678, r = 0.891, both P0.01), and the linear regression equations CVP=5.20 IVCmax / 0.25 and CVP=8.61 IVCmin 2.14.3 were calculated. The cutoff values of CVP-5 cm H2O predicted by IVCDmax,IVCDmin in elderly patients were 1.53 cm (sensitivity 64%, 76% specificity) and 0.69 cm (80%, 88%), respectively. Conclusion 1. IVCmax, IVCmin can predict the blood volume of elderly patients early, timely and accurately. 2. Compared with IVCmax, IVCmin is more effective in predicting blood volume in elderly patients.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R614
本文编号：2431292
[Abstract]:Objective to investigate the relationship between the diameter of inferior vena cava (inferior vena cava diameter,IVCD) and central venous pressure (central venous pressure,CVP) in elderly patients, so as to provide a reference for rapid, effective and non-invasive assessment of the volume status of elderly patients by bedside. Methods from May 2014 to February 2015, 35 elderly patients who were admitted to the ICU ward of the first affiliated Hospital of Suzhou University from May 2014 to February 2015 were enrolled in the study. The central venous catheter was inserted into the right internal jugular vein within 1 hour. The maximum diameter of the posterior inferior hepatic vena cava (inferior vena cava maximum diameter,) was measured by bedside ultrasound before and after the liquid treatment. IVCmax) and the minimum diameter of inferior vena cava (inferior vena cava minimum diameter,IVCmin), and CVP. was measured by water column method at the same time. The changes of IVCD and CVP before and after liquid therapy were compared by paired sample t test, the correlation between IVCD and CVP was analyzed by Pearson correlation analysis, and the optimal critical value of IVCD to predict CVP 5 cm H2O was determined by drawing the receiver operating characteristic curve (receive operating characteristic,ROC). Outcome 1. The IVCmax,IVCmin,CVP before and after liquid therapy were (1.26 卤0.30) cm, (0.42 卤0.21) cm, (6.06 卤2.14) cm H 2O and (1.48 卤0.25) cm, (0.68 卤0.19) cm, respectively. (7.81 卤1.85) cm H 2O, IVCmax,IVCmin and CVP were significantly different before and after liquid therapy (P0.05). There was a positive correlation between IVCmax,IVCmin and CVP in elderly patients (r = 0.678, r = 0.891, both P0.01), and the linear regression equations CVP=5.20 IVCmax / 0.25 and CVP=8.61 IVCmin 2.14.3 were calculated. The cutoff values of CVP-5 cm H2O predicted by IVCDmax,IVCDmin in elderly patients were 1.53 cm (sensitivity 64%, 76% specificity) and 0.69 cm (80%, 88%), respectively. Conclusion 1. IVCmax, IVCmin can predict the blood volume of elderly patients early, timely and accurately. 2. Compared with IVCmax, IVCmin is more effective in predicting blood volume in elderly patients.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R614
【共引文献】
相关期刊论文 前1条
1 孙建锋;;B超检查对于ICU中肺急性间质疾病的诊断作用探析[J];吉林医学;2012年25期
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