国人肾下段下腔静脉测量及分析

MeasurementandanalysisofinfrarenalinferiorvenacavaoftheChinese

目的：探讨正常国人肾下段下腔静脉（ＩＶＣ）ＣＴ测量值，为国产下腔静脉滤器的设计及放置提供依据。材料与方法：对１００例正常国人用ＣＴ机分别测量平静呼吸及Ｖａｌｓａｌｖａ动作后肾下段下腔静脉长轴、短轴两组数据。结果：平静呼吸时ＩＶＣ修正后直径的几何均数为１９．３７ｍｍ（１４．３０～２４．４０ｍｍ），呈偏态分布，与体表面积无直线相关关系。性别和各年龄组间ＩＶＣ修正直径值无显著差异（Ｐ＞０．０５）。Ｖａｌｓａｌｖａ动作后ＩＶＣ修正直径的几何均数为２１．２３ｍｍ（１５．６０～２８．７０ｍｍ）。经ｔ检验，Ｖａｌｓａｌｖａ动作后ＩＶＣ修正直径显著大于平静呼吸时ＩＶＣ的修正直径（Ｐ＜０．０５）。结论：ＣＴ可以直接测量生理状态下ＩＶＣ大小和变化，具有简便和准确的特点。为避免对ＩＶＣ大小估计不足，放置下腔静脉滤器时应以Ｖａｌｓａｌｖａ动作时的修正直径作为参考。

Purpose:Tomeasurethediametersofinfrarenalinferiorvenacava(IVC)inthenor-malpopulationoftheChineseforthedesignandplacementofself-madevenacavalfilter.MaterialsandMethods:Studiedpopulation:100healthpeopleincluing68malesand32femalesranginginagefrom31to78years.TheCTscanwasobtained0.50to1cmbelowtherenalvein.Weperformedthefolowingmeasurements:thelongaxisandshortaxisofIVCduringnaturalrespirationandanearlystageofValsalva′smaneuver.Results:ThecalculatedaveragediametersduringnaturalrespirationandatearlystageofValsalva′smaneuverwere19.37mm(range14.30～24.40mm)and21.23mm(15.60～28.70mm)respectively.Therewasnopositiverelevancebetweencavalsizeandbodysur-faceareas.Therewasnostatisticalysignificantdiferenceincavaldiametersamongthetwosexsanddiferentagegroups.ThecalculatedaveragediametersatearlystageofValsalva′smaneuverwerestatisticalylarger(mean9.03%)thanthatduringnaturalrespiration.Conclusion:CTisareliablemethodtomeasurethetruediameterofIVCunderphysiologicalconditions.Inouropinion,itisad-visabletotakethecalculateddiameterofIVCatanearlystageofValsalva′smaneuverasanindexforselectingintracavalfilterinordertoreducetheriskofplacinganundersizefilter.