呼吸状态对肝硬化患者下腔静脉内径改变的影响

Effect of respiratory status on change of internal diameter of inferior vena cava in patients with liver cirrhosis

目的观察不同呼吸状态下的下腔静脉内径改变情况,探讨其与呼吸状态的关系。方法选取2015年1-5月该院治疗的肝硬化患者76例作为病例组,70例门诊健康体检者作为对照组,超声检查两组患者平静呼吸状态下及深吸气后下腔静脉。结果病例组下腔静脉内径/体表面积(VCD)为(9.72±3.20)mm/m2,明显低于对照组的(13.56±4.92)mm/m2,比较差异有统计学意义(P<0.05);病例组右心房压明显高于对照组,差异有统计学意义(P<0.05);对照组平静呼吸状态下的下腔静脉最大横截面宽、高及截面积明显大于深吸气后,差异有统计学意义(P<0.05);病例组平静呼吸状态下和深吸气后的下腔静脉最大横截面宽、高及截面积比较差异无统计学意义(P>0.05)。结论健康人群平静呼吸状态下和深吸气后下腔静脉内径超声改变明显,而肝硬化患者平静呼吸状态下和深吸气后下腔静脉内径超声改变不明显,这可能与肝脏组织变形、变硬有关。

Objective To observe the change of the inferior vena cava internal diameter under different respiratory status,and to explore its relationship with respiratory status.Methods Seventy-six cases of liver cirrhosis treated in the hospital from January to May 2015 were selected as the case group,at the same time,70 persons undergoing healthy physical examination as the healthy control group.The inferior vena cava in quiet breathing state and after deep inspiration was detected by ultrasonography in the two groups.Results The internal diameter of the inferior vena cava/body surface area（VCD）in the case group was（9.72±3.20）mm/m2,which was significantly lower than（13.56±4.92）mm/m2 in the healthy control group,the difference was statistically significant（P〈0.05）;the right atrial pressure in the case group was significantly higher than that in the healthy control group,the difference was statistically significant（P〈0.05）;the width and height of maximum cross section and cross-sectional area of the inferior vena cava under quiet respiration in the healthy control group were significantly higher than those after deep inspiratory,the difference was statistically significant（P〈0.05）;the width and height of maximum cross section and cross-sectional area of the inferior vena cava in the case group had no statistical difference between quiet breathing state and after deep inspiration（P〉0.05）.Conclusion The ultrasonographic change of inferior vena cava inner diameter is obvious in the quiet breathing state and after deep inspiration,but which in liver cirrhosis is unobvious,which may be related to the deformation and hardening of the liver tissue.