急重症患者锁骨下静脉与下腔静脉超声测值的相关性分析

目的分析急重症患者锁骨下静脉(SCV)与下腔静脉(IVC)各超声测值的相关性,探讨锁骨下静脉检查对评估急重症患者容量状态的应用价值.方法应用超声对非机械通气的急重症患者进行SCV及IVC呼气时最大内径(Dmax)及吸气时最小内径(Dmin)的测量,并记录各自所用时间,计算塌陷指数(CI).部分有深静脉置管患者同时测定中心静脉压(CVP).分析SCV与IVC的内径和CI的相关性,CVP与SCV、IVC各测值的相关性,并将IVC及SCV超声检查所需时间进行对比.结果相关性检验结果显示,SCV的Dmax、Dmin、CI分别与IVC的Dmax、Dmin、CI均呈明显相关性(r=0.792、0.836、0.752,P<0.01).CVP与IVC的Dmax、Dmin、CI均呈一定相关性(r=0.721、0.861、0.546,P<0.01),CVP与SCV的Dmax、Dmin、CI也呈不同程度的相关性(r=0.576、0.742、0.359,P<0.01).SCV超声检查时间[(85±24)s]比IVC超声检查时间[(101±32)s]短(P<0.01).结论对于非机械通气的急重症患者,锁骨下静脉检查或许可作为下腔静脉检查的辅助方法,对评估急重症患者容量状态有一定的应用价值.

Obetive To analyze the crrelation between subclavian vein(SCV)and inferior vena cava(IVC)cllapse index mesured by ulraound in acute and severe patients and to explore the application value of subclavian vein examination in evaluating the capacity state of acute and severe patients.Methods The maximal dianeter(Dmax)and minimum diameter(Dmin)of SCV and IVC were measured by ultrasound in acute and severe patients without mechanical ventilation.The collapse index(C)was calculated.Central venous pressure(CVP)was measured simultaneously in some patients with deep venous catheterization.The correlation between the inner diameter and ollapse index(C)of SCV and IVC was analyzed.The correlation between CVP and the measured values of SCV and IVC was analyzed.The time required for IVC and SCV ultrasonography was compared.Results The results of crrelaion test showed that the measured values of SCV were signific antly correlated with IVC(r=0.792,0.836 and 0.752,P<0.01).There was a certain correlation between CVP and the measured values of IVC(r-0.721.0.861,0.546,P<0.01).There was also a diferent degree of orrelation between CVP and the measured values of SCV(r=0.576,0.742,0.359,P<0.01).In addition,compared with IVC ultrasound(101±32 s),the time required for SCV examination was shorter(85±24 s,P<0.01).Conclusion For acute and severe patients without mechanical ventilation.SCV may be used as an auxiliary means of IVC examination,which has a certain application value in evaluating the volume status of acute and severe patients.