超声评估颈内静脉直径预测产妇仰卧位低血压综合征

Ultrasound measurement of the internal jugular vein diameter for predicting supine hypotension syndrome in parturient

目的:观察产妇侧卧位与仰卧位时颈内静脉的前后径变异情况与仰卧位低血压综合征的关系。方法:观察50例需在腰椎麻醉下进行剖宫产手术的孕妇。应用超声在麻醉前分别评估孕妇仰卧位与左侧卧位时右颈内静脉前后直径。记录腰椎麻醉前后的血压及仰卧位低血压综合征的发生率。分析颈内静脉直径变化与仰卧位低血压综合征的相关性。结果:50例产妇腰椎麻醉后17例发生仰卧位低血压综合征。麻醉前产妇仰卧位时的右颈内静脉前后径为(12.7±0.9) mm,侧卧位时右颈内静脉直径为(12.9±0.7) mm。仰卧位与侧卧位时右颈内静脉直径的变化率与仰卧位低血压综合征的发生具有相关性(rs=0.53,P<0.001)。结论:右颈内静脉直径在仰卧位与左侧卧位时发生的变化与产妇仰卧位低血压综合征有相关性,可能是预测产妇麻醉后仰卧位低血压综合征的线索之一。

Objective:To observe the relationship between anterior and posterior diameter change of internal jugular vein in lateral and supine position and supine hypotension syndrome.Methods:Fifty women undergoing cesarean section by spinal anesthesia were recruited,and subjected to measurement of the right internal jugular vein diameter in supine and left lateral position using ultrasound before anesthesia.Blood pressure and incidence of supine hypotension syndrome were recorded before and during spinal anesthesia for analysis of the right jugular vein diameter and incidence of supine hypotension syndrome.Results:Supine hypotension syndrome during anesthesia was noted in 17 of the 50 patients.The right internal jugular vein at anteroposterior diameter was(12.7±0.9)mm by supine position,and(12.9±0.7)mm by lateral position before anesthesia.Incidence of maternal supine hypotension syndrome was related to the diameter of the internal jugular vein by either supine or lateral position(r s=0.53,P<0.001).Conclusion:Incidence of maternal supine hypotension syndrome is associated with the change of internal jugular vein diameter by supine and lateral position,suggesting that measurement of the internal jugular vein diameter can be predictive signs of supine hypotension syndrome for parturient during anesthesia.