中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2015年
6期
491-495
,共5页
张青%刘大为%王小亭%张宏民%何怀武%柴文昭%晁彦公%中国重症超声研究组(CCUSG)
張青%劉大為%王小亭%張宏民%何懷武%柴文昭%晁彥公%中國重癥超聲研究組(CCUSG)
장청%류대위%왕소정%장굉민%하부무%시문소%조언공%중국중증초성연구조(CCUSG)
超声检查%腔静脉,下%横切面%形变指数
超聲檢查%腔靜脈,下%橫切麵%形變指數
초성검사%강정맥,하%횡절면%형변지수
Ultrasonography%Vena cava,inferior%Transversal plane%Shape change index
目的 采用超声观测不同部位的下腔静脉内径形变指数(SCI),为后期探讨下腔静脉内径SCI与重症患者容量状态、容量反应性的关系奠定基础.方法 收集2014年12月-2015年1月入住北京协和医院重症医学科的患者,超声观测剑突下及右侧腹腋中线部位不同呼吸周期的下腔静脉内径形态,计算下腔静脉内径SCI,并进行相关性分析.结果 共入选107例患者,60例患者因不能同时获得剑突下和右侧腹腋中线2个部位观察、或图像质量欠佳未入选本研究,47例患者均同时获得剑突下和右侧腹腋中线下腔静脉横切面的观察,男性26例,女性21例,年龄(59.1±18.7)岁;完全机械通气者5例,自主呼吸者42例.不同部位、不同呼吸状态下腔静脉纵切面下腔静脉内径值比较差异有统计学意义(P＜0.05).吸气末下腔静脉横切面下腔静脉内径SCI剑突下为1.87±0.72,右侧腹腋中线为1.85±0.59,差异无统计学意义(P＞0.05).呼气末下腔静脉横切面下腔静脉内径SCI剑突下为1.69±0.47,右侧腹腋中线为1.74±0.50,差异无统计学意义(P＞0.05).相关性分析:横切面吸气末下腔静脉长径值、短径值、下腔静脉内径SCI,剑突下与右侧腹腋中线有相关性(r =0.866,P=0.000;r =0.887,P=0.000;r=0.424,P=0.003);横切面呼气末下腔静脉长径值、短径值、下腔静脉内径SCI,剑突下与右侧腹腋中线有相关性(r=0.802,P=0.000;r=0.887,P=0.000;r =0.883,P=0.000).结论 剑突下和右侧腹腋中线横切面、不同呼吸周期下腔静脉的长径、短径及下腔静脉内径SCI有良好的一致性与相关性,两个部位的测量可以相互替代.
目的 採用超聲觀測不同部位的下腔靜脈內徑形變指數(SCI),為後期探討下腔靜脈內徑SCI與重癥患者容量狀態、容量反應性的關繫奠定基礎.方法 收集2014年12月-2015年1月入住北京協和醫院重癥醫學科的患者,超聲觀測劍突下及右側腹腋中線部位不同呼吸週期的下腔靜脈內徑形態,計算下腔靜脈內徑SCI,併進行相關性分析.結果 共入選107例患者,60例患者因不能同時穫得劍突下和右側腹腋中線2箇部位觀察、或圖像質量欠佳未入選本研究,47例患者均同時穫得劍突下和右側腹腋中線下腔靜脈橫切麵的觀察,男性26例,女性21例,年齡(59.1±18.7)歲;完全機械通氣者5例,自主呼吸者42例.不同部位、不同呼吸狀態下腔靜脈縱切麵下腔靜脈內徑值比較差異有統計學意義(P＜0.05).吸氣末下腔靜脈橫切麵下腔靜脈內徑SCI劍突下為1.87±0.72,右側腹腋中線為1.85±0.59,差異無統計學意義(P＞0.05).呼氣末下腔靜脈橫切麵下腔靜脈內徑SCI劍突下為1.69±0.47,右側腹腋中線為1.74±0.50,差異無統計學意義(P＞0.05).相關性分析:橫切麵吸氣末下腔靜脈長徑值、短徑值、下腔靜脈內徑SCI,劍突下與右側腹腋中線有相關性(r =0.866,P=0.000;r =0.887,P=0.000;r=0.424,P=0.003);橫切麵呼氣末下腔靜脈長徑值、短徑值、下腔靜脈內徑SCI,劍突下與右側腹腋中線有相關性(r=0.802,P=0.000;r=0.887,P=0.000;r =0.883,P=0.000).結論 劍突下和右側腹腋中線橫切麵、不同呼吸週期下腔靜脈的長徑、短徑及下腔靜脈內徑SCI有良好的一緻性與相關性,兩箇部位的測量可以相互替代.
목적 채용초성관측불동부위적하강정맥내경형변지수(SCI),위후기탐토하강정맥내경SCI여중증환자용량상태、용량반응성적관계전정기출.방법 수집2014년12월-2015년1월입주북경협화의원중증의학과적환자,초성관측검돌하급우측복액중선부위불동호흡주기적하강정맥내경형태,계산하강정맥내경SCI,병진행상관성분석.결과 공입선107례환자,60례환자인불능동시획득검돌하화우측복액중선2개부위관찰、혹도상질량흠가미입선본연구,47례환자균동시획득검돌하화우측복액중선하강정맥횡절면적관찰,남성26례,녀성21례,년령(59.1±18.7)세;완전궤계통기자5례,자주호흡자42례.불동부위、불동호흡상태하강정맥종절면하강정맥내경치비교차이유통계학의의(P＜0.05).흡기말하강정맥횡절면하강정맥내경SCI검돌하위1.87±0.72,우측복액중선위1.85±0.59,차이무통계학의의(P＞0.05).호기말하강정맥횡절면하강정맥내경SCI검돌하위1.69±0.47,우측복액중선위1.74±0.50,차이무통계학의의(P＞0.05).상관성분석:횡절면흡기말하강정맥장경치、단경치、하강정맥내경SCI,검돌하여우측복액중선유상관성(r =0.866,P=0.000;r =0.887,P=0.000;r=0.424,P=0.003);횡절면호기말하강정맥장경치、단경치、하강정맥내경SCI,검돌하여우측복액중선유상관성(r=0.802,P=0.000;r=0.887,P=0.000;r =0.883,P=0.000).결론 검돌하화우측복액중선횡절면、불동호흡주기하강정맥적장경、단경급하강정맥내경SCI유량호적일치성여상관성,량개부위적측량가이상호체대.
objective To investigate the shape change index (SCI) of inferior vena cava (IVC)measured from subcostal area and right mid-axillary line through ultrasonography laying the foundation for future research about SCI and volume status.Methods A total of 107 patients were enrolled in the Critical Care Medicine Department of Peking Union Medical College Hospital from December,2014-January,2015.The maximal diameter(MXD) and the minimal diameter(MID) were measured transversely from subcostal area and right mid-axillary line.The SCI was calculated.Results Totally 47 patients (42 with spontaneous breathing and 5 on mechanical ventilation) achieved measurements on transversal plane from subcostal area and right mid-axillary line.(1) The internal diameter of IVC on longitudinal plane measured from subcostal area was statistically different from that measured from right mid-axillary line both at end inspiration (P =0.001) and at end expiration (P =0.027).(2)No difference were found in the SCI measured from subcostal and right mid-axillary line both at end inspiration and at expiration.(3)The internal diameter of IVC and the SCI measured on transversal plane from subcostal area correlated well with that measured from mid-axillary line both at end inspiration(SCI:r =0.866,P =0.000)and at end expiration(SCI:r =0.887,P =0.000).Conclusions Inferior vena cava internal diameters and the shape change index measured through ultrasonography on transversal planefrom subcostal area are correlated well with those from midaxillary line.Measurements from the two sites can be replacedby each other.
