| 摘要: |
| 目的 探讨心脏外科术后患者的下腔静脉内径及塌陷率与中心静脉压的相关性。方法 选取我院心血管外科重症监护病房的瓣膜置换术后患者84例，于术后48 h内首次进行床旁超声检测，于右锁骨中线与右腋前线的中线上获取经肝的下腔静脉二维长轴超声图像，测量下腔静脉随呼吸变化时的最大横径与最小横径（IVCmax、IVCmin），并计算其管径塌陷率，同时经颈外静脉入上腔静脉导管实时测定中心静脉压（CVP），Spearman及Pearson法分别分析机械通气和自主呼吸状态时IVCmax、IVCmin、塌陷率与CVP的相关性。结果 入组对象的下腔静脉IVCmax为（1.54±0.45）cm，IVCmin为（1.19±0.45）cm，塌陷率为（24.02±11.52）%，CVP为（9.46±4.02）cm H2O（1 cm H2O=0.1 kPa）。IVCmax和IVCmin均与CVP呈正相关（P＜0.01），下腔静脉塌陷率与CVP呈负相关（P＜0.01）。机械通气和自主呼吸患者的IVCmax、IVCmin及下腔静脉塌陷率与CVP均有较好的相关性（P＜0.01）。结论 应用下腔静脉管径和塌陷率可无创预测心脏外科术后患者CVP。动态测量下腔静脉管径，有利于容量反应性的判断。 |
| 关键词: 下腔静脉 中心静脉压 容量反应性 重症超声 |
| DOI： |
| 投稿时间：2018-11-19修订日期：2019-01-11 |
| 基金项目:解放军超声医学专业委员会科研激励(JLJJ2016-002) |
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| The correlation between the diameter of inferior vena cava and central venous pressure in patients after cardiac surgery |
| zeng ziling,liuzheng |
| (Second Affiliated Hospital of Army Medical University) |
| Abstract: |
| Objective To find the correlation between the diameter and collapsibility of the inferior vena cava （IVC） and the CVP in patients after cardiovascular surgery. Methods Eighty-four patients after the cardiac valve replacement in Xinqiao hospital were into group. The maximal and minimal transverse diameter(IVCmax and IVCmin) were measured in the two-dimensional long axis view of the IVC，obtained on the midline of the right clavicle midline and axillary line，then the collapsibility of IVC diameter was calculated. While CVP was measured by external jugular vein into superior vena cava catheter. The correlation between IVCmax, IVCmin, collapsibility and CVP were analyzed by Spearman’s and Pearson’s methods in spontaneous or mechanical ventilation condition respectively.
Results IVCmax is （1.54±0.45） cm，IVCmin is （1.19±0.45） cm，collapsibility is （24.02±11.52）%, CVP is （9.46±4.02） cmH2O. Either in a spontaneous or mechanical ventilation condition，a negative correlation was observed between IVC collapsibility and CVP （P＜0.01），while there is a positive one between IVC diameter and CVP （P＜0.01）.
Conclusion For patients after cardiac valve replacement，both the diameter and the collapsibility of IVC were related to the CVP. Using ultrasound to measure the diameter of IVC，is conducive to the determination of fluid responsiveness. |
| Key words: Inferior vena cava Central venous pressure Fluid responsiveness Critical ultrasound |
