超声监测下腔静脉直径对多发性外伤患者术后血容量状态监测的价值研究

The clinical values of inferior vena cava diameter in postoperative blood volume condition monitoring for patients with multiple trauma patients

目的探讨超声监测下腔静脉直径对多发性外伤患者术后血容量状态监测的价值。方法选择30例多发性外伤患者,监测患者术后24小时中心静脉压(CVP)及呼气末的下腔静脉最大直径(IVCe)及吸气末的下腔静脉最小直径(IVCi)的变化,并分析CVP与IVCe、IVCi的相关性。结果患者治疗前后的CVP分别为(13.40±1.42)cm H_2O,(9.06±0.54)cm H_2O,IVCe分别为(2.04±0.15)cm,(1.86±0.14)cm,IVCi分别为(1.90±0.12)cm、(1.73±0.11)cm。治疗前后差异有统计学意义,P均小于0.01。液体治疗前后IVCe、IVCi分别与CVP呈正相关。治疗前后IVCe、IVCi变化值与CVP变化值呈正相关。结论下腔静脉直径监测对多发性外伤患者术后血容量状态监测具有重要意义,可有效反映患者血容量状态,指导临床治疗。

Objective ： To evaluate the clinical values of inferior vena cava diameter in postoperative blood volume condition monitoring for patients with multiple trauma patients. Methods： The central venous pressure （CVP） and the IVC diameters during expiration （IVCe） and inspiration （IVCi） changes were monitored for 24 hours after surgery in 30 multiple trauma patients. And the correlation between CVP and/VCe, IVCi was analyzed. Results： CVP of patients were （ 13.40 ± 1.42） cmH2O, （9.06±0.54） cmH2O, IVCe were （2.04 ±0.15） cm, （ 1.86 ±0.14） cm, IVCi were （ 1.90 ±0.12） cm, （ 1.73 ± 0.11 ） cm before and after treatment. Difference before and after treatment was statistically significant （ P 〈 0.01 ）. CVP were positively correlated with the IVCe and IVCi respectively, and the change value of IVCe and IVCi was positively correlated with CVP before and after the treatment. Conclusion： The monitoring of IVC has great significance in postoperative condition monitoring for patients with multiple trauma patients, which can reflect the patienth blood volume effectively, and guide clinical treatment.