CAJ | 학술논문

目的评价超声法测量下腔静脉(IVC)直径用于评估老年患者术前血容量的准确性.方法择期拟行前列腺电切术患者60例,年龄60 ～ 75岁,体重指数20～25 kg/m2,ASA分级Ⅰ-Ⅲ级,采用随机数字表法分为3组(n=20):对照组(C组)、乳酸钠林格氏液组(RL组)和羟乙基淀粉组(H组).C组不给予任何液体;RL组静脉输注乳酸钠林格氏液8 ml/kg;H组静脉输注6％羟乙基淀粉130/0.4 8 ml/kg.于液体治疗前(T1)和治疗后(T2)记录SpO2 MAP、HR和CVP,超声引导下测量IVC的最大直径(IVCe)和最小直径(IVCi),计算下腔静脉呼吸衰减指数(IVC-CI).结果与T1时比较,RL组和H组T2时IVCe、IVCi增加,IVC-CI降低(P＜0.05).与C组比较,RL组和H组T2时IVCe、IVCi增加,IVC-CI降低(P＜0.05).IVCe及IVCi与CVP呈正相关(r分别为0.746、0.697,P＜0.01);IVC-CI与CVP呈负相关(r=-0.547,P＜0.01).结论超声法测量IVC直径用于评估老年患者术前血容量的准确性较好.
목적 평개초성법측량하강정맥(IVC)직경용우평고노년환자술전혈용량적준학성.방법 택기의행전렬선전절술환자60례,년령60 ～ 75세,체중지수20～25 kg/m2,ASA분급Ⅰ-Ⅲ급,채용수궤수자표법분위3조(n=20):대조조(C조)、유산납림격씨액조(RL조)화간을기정분조(H조).C조불급여임하액체;RL조정맥수주유산납림격씨액8 ml/kg;H조정맥수주6％간을기정분130/0.4 8 ml/kg.우액체치료전(T1)화치료후(T2)기록SpO2 MAP、HR화CVP,초성인도하측량IVC적최대직경(IVCe)화최소직경(IVCi),계산하강정맥호흡쇠감지수(IVC-CI).결과 여T1시비교,RL조화H조T2시IVCe、IVCi증가,IVC-CI강저(P＜0.05).여C조비교,RL조화H조T2시IVCe、IVCi증가,IVC-CI강저(P＜0.05).IVCe급IVCi여CVP정정상관(r분별위0.746、0.697,P＜0.01);IVC-CI여CVP정부상관(r=-0.547,P＜0.01).결론 초성법측량IVC직경용우평고노년환자술전혈용량적준학성교호.
Objective To evaluate the accuracy of ultrasound-measured inferior vena cava (IVC) diameter in assessment of the preoperative blood volume in elderly patients.Methods Sixty patients,aged 60-75 yr,with body mass index 20-25 kg/m2,of ASA physical status Ⅰ-Ⅲ,scheduled for elective transurethral resection of prostate,were randomly divided into 3 groups (n =20 each):control group (group C),lactated Ringer's solution group (group RL),and hydroxyethyl starch group (group H).Lactated Ringer's solution 8 ml/kg was infused intravenously in group RL.Hydroxyethyl starch 130/0.4 8 ml/kg was infused intravenously in group H.SpO2,mean arterial pressure (MAP),HR and central venous pressure (CVP) were monitored before and after fluid therapy.The IVC diameters,both during expiration (IVCe) and inspiration (IVCi),were measured using ultrasound.IVC collapsibility index (IVC-CI) was calculated.Results The IVCeand IVCi were significantly increased,and IVC-CI was decreased after fluid therapy as compared with those before fluid therapy in RL and H groups.Compared with group C,the IVCe and IVCi were significantly increased,and IVC-CI was decreased after fluid therapy in RL and H groups.IVCe and IVCi were positively correlatedwith CVP (r=0.746 and 0.697,respectively).IVC-CI was negatively correlated with CVP (r =-0.547).Conclusion Ultrasoundmeasured IVC diameter provides better accuracy in assessing the preoperative blood volume in elderly patients.