腹部静脉多普勒血流模式在容量管理中的应用

Application of abdominal venous Doppler flow pattern in volume management

准确的血流动力学状态评估对于容量管理至关重要。容量超负荷导致的静脉充血可引起器官损伤和预后不良。下腔静脉超声、心脏超声和肺部超声等传统重症超声已广泛应用于容量管理,但均无法评估器官血流。腹部静脉血流模式随静脉充血而动态变化,是肝静脉、门静脉和肾内静脉血流的超声多普勒评估指标。本文对腹部静脉血流模式的获取与分级标准及其在容量管理中的应用和局限性进行综述,以期为临床早期识别终末器官充血、实施液体负平衡干预和个体化容量管理提供帮助。

Accurate assessment of hemodynamic status is crucial for volume management.Venous congestion caused by volume overload can cause organ damage and poor prognosis.Traditional critical ultrasound,including inferior vena cava ultrasound,echocardiography,and lung ultrasound,is widely used in volume management.However,it is unable to evaluate the organ blood flow.The blood flow pattern of abdominal vein changes dynamically with venous congestion,which is an index for evaluating the blood flow of hepatic vein,portal vein and internal renal vein by Doppler ultrasound.This article reviews the acquisition and grading standards of abdominal venous blood flow patterns,their application and limitations in volume management,with a view to providing help for early clinical identification of terminal organ congestion,implementation of fluid negative balance intervention and individualized volume management.