不同体位下腔静脉直径及其变异度的相关性分析

Correlation Analysis of Inferior Vena Cava Diameter and Its Variability in Different Body Positions

目的探讨床头抬高30°斜卧位能否替代仰卧位作为超声测量下腔静脉直径(IVCD)评估血容量的体位。方法选择金堂县第二人民医院重症医学科2021年1月—2023年1月的60例重症患者,在仰卧和床头抬高30°斜卧两种体位下用超声测量IVCD最大值、最小值和变异度,t检验比较两种体位IVCD差异,组内相关系数(r)进行一致性评价。结果仰卧位IVCD平均最小值[(1.43±0.47)cm]、平均最大值[(1.76±0.46)cm]和平均变异度[(26.46±18.40)%]与床头抬高30°斜卧位IVCD平均最小值[(1.46±0.43)cm]、平均最大值[(1.78±0.43)cm]和平均变异度[(24.38±16.60)%]比较无统计学意义(P>0.05)。组内相关系数表明两种体位IVCD的最小值(r=0.932)和最大值(r=0.915)具有很好的一致性,变异度(r=0.728)具有一致性。进一步的亚组分析也得出了类似结果。结论床头抬高30°斜卧位可替代仰卧位作为测量IVCD的体位用于评估重症患者的血容量,有一定的临床应用价值。

Objective To explore whether a 30°bed head elevation position can replace a supine position as a position for ultrasound measurement of inferior vena cava diameter(IVCD)to reflect blood volume.Methods A total of 60 severe patients from the Department of Intensive Care Unit of The Second People’s Hospital of Jintang County from January 2021 to January 2023 were selected.The maximum,minimum and variability of IVCD were measured by ultrasound in both supine and bed head elevated 30°position.Student’s t-test was used to compare the difference in IVCD between the two positions,and intra-class correlation coefficient(r)were used for consistency evaluation.Results There was no statistical significance in comparing the mean minimum[(1.43±0.47)cm],mean maximum[(1.76±0.46)cm],and mean variability[(26.46±18.40)%]of IVCD in the supine position with the mean minimum[(1.46±0.43)cm],mean maximum[(1.78±0.43)cm],and mean variability[(24.38±16.60)%]of IVCD in the 30°bed head elevation position(P>0.05).The intra-class correlation coefficient showed excellent consistency in the minimum(r=0.932)and maximum(r=0.915)of IVCD for the two positions,and consistency in the variability(r=0.728).Further subgroup analysis yielded similar results.Conclusion The 30°bed head elevation position may be used as an alternative to the supine position for IVCD measurement during assessment of blood volume in severe patients,and has certain clinical application value.