下腔静脉与心胸比评估血透患者干体重的研究

Research in Inferior Vena Cava and Cardiothoracic Ratio Assessment of Hemodialysis Patients

目的探讨下腔静脉直径（VCD）与后前位胸片心胸比在血透患者干体重的临床应用。方法对96例血透患者进行血透前、后测量下腔静脉直径，同时作心胸比的测定，结合干体重的临床表现三者对比研究。结果血透前后VCD有明显差异P〈0.01，心胸比对无症状血透患者，血透前后当时则无明显改变，对有明显急性心衰、有大量水钠潴留患者稍有增大占3．5％，3～4周后，心衰症状消失。心胸比恢复至原状〈50％。结论VCD能及时、正确地观察血透患者的干体重，结合临床表现，心胸比具有可靠的参考价值。心胸比具有迟后性，X光胸片表现比较晚。

Objective We explored some clinic application methods for hemodialysis patients＇s net weight treatment by looking into the diameters of the inferior vena cava（VCD） and the cardiothoracic ratio of anteposition and retroposition chest X-ray. Methods We have studied 96 cases of hemodialysis patients. We measured the diameters of the inferior vena cava before and after the patients took the hemodialysis treatment respectively. We also recorded the cardiothoracic ratio data and the clinic status of the patients＇ net weight. Combining and contrasting these data leads to the following Results There are distinct difference between the VCD data before and after the hemodialysis treament（P〈 0.01）. The cardiothoracic ratio didn＇t change distinctly to hemodialysis patients who had no symptom, To those patients who showed the symptom of acute heart failure（AHF） and water sodium retention, 3.5% of the patients＇ cardiothoracic ratio increased slightly. The symptom of acute heart failure（AHF） disappeared after three or four weeks. Less than 50% of the patients＇ cardiothoracic ratio recovered to normal. Conclusion VCD is a rapid and accurate method for observing the net weight of the hemodialysis patients. When combing with the clinic status, the cardiothoracic ratio is of great reference value and reliable. The cardiothoracic ratio result may be time delay and the showing of chest X-ray can also be lagged.