Correlation of radius and respiration variation of inferier vena cava with central venous pressure in reneu failure patients
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摘要: 目的：观察连续肾脏替代治疗（CRRT）过程中中心静脉压（CVP）与下腔静脉（IVC）管径、呼吸变异指数（RVI）之间的关系，探讨使用床边超声进行快速评估血容量的可行性。方法：以我院急诊重症监护病房（EICU）收治的因肾功能衰竭需行CRRT治疗的20例患者为CRRT组，在CRRT治疗过程中记录CVP的变化，同时使用超声测量对应时间段的IVC管径，并计算RVI；另选择有肾功能不全但无需血液净化治疗的EICU患者21例作为对照组，比较2组数据。对IVC管径、RVI与CVP进行相关性分析；使用IVC管径及RVI预测CVP 12 cmH2O（1 cmH2O=0.098 kPa）时的界值。结果：CRRT组患者下腔静脉管径明显大于对照组（P<0.01），呼吸变异指数明显低于对照组（P<0.01）；CRRT组IVCmax、IVXmin均与CVP呈正相关（r=0.868，P<0.01；r=0.763，P<0.01）；RVI与CVP呈负相关（r=-0.848，P<0.01）；IVCmax、IVCmin、RVI预测CVP 12 cmH2O的界值分别为14.0 mm（敏感度91.9%、特异度93.1%）、9.2 mm（敏感度83.5%、特异度85.5%）；29.3%（敏感度89.4%、特异度92.5%）。结论：床旁超声测量IVC可以在一定程度上预测CVP，为临床医师快速评估肾衰患者血容量提供参考。Abstract: Objective: To investigate the relationship between CVP and IVC,RVI in CRRT,and to investigate the feasibility of the use of bedside ultrasound.Method: CRRT patients for the study,20 cases of the treatment group,CVP record changes in CRRT treatment,while using ultrasound measurements IVC,computing RVI.Result: EICU not CRRT patients as a control group of 21 cases,and the control group IVC and RVI were compared for IVC,RVI and CVP correlation analysis.Conclusion: IVC bedside ultrasound measurements can predict CVP,provide a reference for clinicians to quickly assess blood volume.
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