超聲下探討老年患者下腔靜脈管徑與中心靜脈壓的相關(guān)性
發(fā)布時(shí)間：2019-02-27 08:39
【摘要】：目的探討老年患者下腔靜脈管徑(inferior vena cava diameter,IVCD)與中心靜脈壓(central venous pressure,CVP)的關(guān)系,為床邊快速有效且無(wú)創(chuàng)地評(píng)估老年患者的容量狀態(tài)提供參考。方法選取2014年5月至2015年2月蘇州大學(xué)附屬第一醫(yī)院中心ICU病房(surgical intensive care unit,SICU)收治的老年患者35例為研究對(duì)象,于右頸內(nèi)靜脈置入中心靜脈導(dǎo)管后于1小時(shí)內(nèi)滴入乳酸林格氏液6ml/Kg,于液體治療前、液體治療后床邊超聲測(cè)量肝后下腔靜脈最大徑(inferior vena cava maximum diameter,IVCmax)和下腔靜脈最小徑(inferior vena cava minimum diameter,IVCmin),同時(shí)用水柱法測(cè)量CVP。采用配對(duì)樣本t檢驗(yàn)比較液體治療前后IVCD及CVP的變化;采用Pearson相關(guān)性分析了解IVCD與CVP的相關(guān)性;繪制受試者工作特征曲線(receive operating characteristic,ROC)確定IVCD預(yù)測(cè)CVP 5 cm H2O的最佳臨界值。結(jié)果1.老年患者液體治療前IVCmax、IVCmin、CVP分別為(1.26±0.30)cm、(0.42±0.21)cm、(6.06±2.14)cm H2O,液體治療后IVCmax、IVCmin、CVP分別為(1.48±0.25)cm、(0.68±0.19)cm、(7.81±1.85)cm H2O,液體治療前后IVCmax、IVCmin及CVP均有顯著性差異(P0.05)。2.老年患者IVCmax、IVCmin與同期CVP呈正相關(guān)(r=0.678、r=0.891,均P0.01),并計(jì)算出線性回歸方程CVP=5.20 IVCmax 0.25和CVP=8.61 IVCmin+2.14。3.老年患者IVCDmax、IVCDmin預(yù)測(cè)CVP 5 cm H2O的界值分別為1.53 cm(敏感度64%,特異度76%)、0.69 cm(敏感度80%,特異度88%)。結(jié)論1.IVCmax、IVCmin可以早期、及時(shí)、準(zhǔn)確地預(yù)測(cè)老年患者的血容量。2.與IVCmax相比,IVCmin對(duì)老年患者的血容量的預(yù)測(cè)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 鹵0.30) cm, (0.42 鹵0.21) cm, (6.06 鹵2.14) cm H 2O and (1.48 鹵0.25) cm, (0.68 鹵0.19) cm, respectively. (7.81 鹵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.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R614
本文編號(hào)：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 鹵0.30) cm, (0.42 鹵0.21) cm, (6.06 鹵2.14) cm H 2O and (1.48 鹵0.25) cm, (0.68 鹵0.19) cm, respectively. (7.81 鹵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.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R614
【共引文獻(xiàn)】
相關(guān)期刊論文 前1條
1 孫建鋒;;B超檢查對(duì)于ICU中肺急性間質(zhì)疾病的診斷作用探析[J];吉林醫(yī)學(xué);2012年25期
，本文編號(hào)：2431292
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