下腔静脉扩张指数对AECOPD心功能的评估

Evaluation of Cardiac Function in AECOPD by Inferior Vena Cava Dilatation Index

目的:评估下腔静脉扩张指数(d IVC)对危重患者心功能改善的指导价值。方法:选取2017年2月~2018年12月我院重症监护病房(ICU)收治的58例慢性阻塞性肺疾病急性加重(AECOPD)并行机械通气治疗患者为研究对象,在遵循随机数字表分配原则的基础上采用双盲法分为对照组(29例)和研究组(29例),对照组以中心静脉压(CVP)指导液体治疗,研究组以重症超声反复监测d IVC指导液体治疗,围绕心率、氧合指数(PaO2/FIO2)及脑利钠肽前体(NT-pro BNP)水平行组间和组内对比。结果:组内结果显示:治疗后两组心率、PaO2/FIO2及NT-pro BNP均显著改善,差异有统计学意义(P<0.05);组间结果显示:治疗后研究组心率低于对照组,PaO2/FIO2水平高于对照组,NT-pro BNP水平低于对照组,差异有统计学意义(P<0.05)。结论:d IVC对AECOPD等危重患者的超声治疗更具有指导价值,对维持心率正常、提升PaO2/FIO2水平、降低NT-pro BNP水平均有显著效果,值得临床使用。

Objective: To evaluate the guiding value of inferior vena cava dilatation index(dIVC) in the improvement of cardiac function in critically ill patients. Methods: From February 2017 to December 2018, 58 patients with acute aggravation of chronic obstructive pulmonary disease(COPD)and mechanical ventilation were selected from(ICU) in intensive care unit of our hospital. On the basis of following the principle of random digital table allocation, the control group(29 cases) and the study group(29 cases) were divided into control group(29 cases) and study group(29 cases) by double blind method. The control group was guided by central venous pressure(CVP), and the study group was guided by severe ultrasound monitoring dIVC. Around heart rate, oxygenation index(PaO2/FIO2) and brain natriuretic peptide precursor(NT-proBNP) levels Line and intra-group comparison. Results: The results of the group showed that the heart rate, PaO2/FIO2 and NT-proBNP were significantly improved in the two groups after treatment, and the difference was statistically significant(P<0.05). The results between the groups showed that the heart rate of the study group was lower than that of the control group after treatment. The level of PaO2/FIO2 was higher in the control group than in the control group, and the difference was statistically significant(P<0.05). Conclusions: dIVC has more guiding value for ultrasound treatment of critical patients such as AECOPD,and has significant effect on maintaining normal heart rate, increasing PaO2/FIO2 level and reducing NT-proBNP level, which is worthy of clinical use.