下腔静脉内径呼吸变异度对休克患者容量反应性的评估价值

摘要

Objective To explore the clinical application value of the respiratory variation index of the inferior vena cava internal diameter in shock patients. Method 60 cases of septic shock in our hospital from January 2015 to October 2015 were selected and divided into response group (n = 21) and non-response group (n = 39) according to the result of rehydration experimental. Then exploring the predicting value of respiratory variation index of the inferior vena cava internal diameter in volume responsiveness. Result The respiratory variation index of the inferior vena cava internal diameter, the variation of systolic pressure, variation of pulse pressure, variation of stroke volume, variation of cardiac index in response group were significantly higher than that of non-response group (P < 0.05). Pearson correlation analysis showed that the level of respiratory variation index of the inferior vena cava internal diameter in patients with shock was positively related to the variation of systolic pressure, variation of pulse pressure, variation of stroke volume, variation of cardiac index (P < 0.05). Conclusion The respiratory variation index of the inferior vena cava internal diameter has a close correlation with the rate of respiratory variability, which can be used to guide fluid resuscitation in patients with septic shock.%目的 探讨下腔静脉内径呼吸变异度评估休克患者容量反应性的临床应用价值.方法 选择2015年1月至2015年12月本院收治的60例感染性休克患者为研究对象,入选患者均经床旁超声检测下腔静脉内径呼吸变异度,行补液试验,将补液后每搏量≥10%者纳入反应组(21例),每搏量<10%者纳入无反应组(39例),监测补液前后患者的血流动力学变化,并判断患者的容量反应性.结果 反应组患者下腔静脉内径呼吸变异度、收缩压变异度、脉压差变异度、每搏量变异度、心脏指数变异度均明显高于无反应组(P<0.05).感染性休克患者下腔静脉内径呼吸变异度与收缩压变异度、脉压变异度、每博变异度、心脏指数变异度均呈正相关(P<0.05).结论 下腔静脉内径呼吸变异度与休克患者容量反应性密切相关,可用于指导感染性休克患者进行液体复苏.