超声测量SCI对严重妊高征患者剖宫产术后血容量状态评估的应用探讨

A Study of Measuring Inferior Vena Cava Internal Diameter in Gestational Hypertension after Operation by Ultrasonongraphy

目的:本研究探讨超声测量严重妊娠期高血压(妊高征)行剖宫产术后患者的下腔静脉内径形变指数(SCI)与血容量状态的相关性。方法:选取我院收治外科ICU的妊高征行剖宫产手术(无机械通气)患者为研究对象,根据中心静脉压(CVP)水平分为A组(CVP<5mm Hg)、B组(CVP5-12mm Hg)、C组(CVP>12mm Hg)。超声测量右侧腹腋中线位置呼气末下腔静脉(IVC)横切面长、短内径值,计算SCI,并与CVP进行pearson相关性分析。结果:共计43例患者纳入研究,其中A组10例,B组22例,C组11例,三组患者年龄、心率、平均动脉压、乳酸水平等临床资料无统计学意义(P>0.05);IVC的长、短径与CVP均呈正相关,SCI与CVP呈负相关;SCI判断CVP<5mm Hg的ROC曲线分析结果,AUC为0.938,诊断界值1.78,敏感度95.3,特异度84.3;SCI判断CVP>12mm Hg的ROC曲线分析结果,AUC为0.952,诊断界值1.2,敏感度94.9,特异度85.2。结论:超声测量下腔静脉内径形变指数可以比较准确评估严重妊娠期高血压行剖宫产术后患者的血容量状态。

Objective： To investigate the correlation between the diameter of the inferior vena cava （SCI） and the bloodvolume of the patients with severe pregnancy induced hypertension （pregnancy induced hypertension） after cesarean section.Methods：Select our hospital surgical ICU of pregnancy induced hypertension （PIH Zhenghang cesarean section operation（without mechanical ventilation） patients as the research object,according to the central venous pressure （CVP） levels weredivided into group A （CVP〈5mmHg） of the A,B CVP5-12mmHg,C group CVP〉12mmHg.The long and short diameter of theend expiratory inferior vena cava （IVC） were measured by ultrasonography in the right abdominal axillary midline position.TheSCI was calculated and the correlation with Pearson was analyzed by CVP.Results：Total 43 cases were included in the study,of which a group of 10 cases, group B （22 cases） and C group （11 cases）,the clinical data of the three groups of patients withage,heartrate,mean arterial pressure,lactate levels without statistical significance （P〉0.05）;IVC of the long and short diameterand CVP were positively correlated,SCI and CVP were negative correlation;the ROC curve of SCI judgment CVP〈5mmHganalysis results,AUC was 0.938.Diagnosis of the critical value of 1.78,sensitivity 95.3 and specificity of 84.3;analysis of theROC curve of SCI judgment CVP〉12mmHg results,the AUC was 0.952,community diagnosis value of 1.2,sensitivity of 94.9specificity 85.2.Conclusion：Ultrasound measurement of the inner diameter of the inferior vena cava can be more accurateassessment of the blood volume of patients with severe pregnancy induced hypertension.