颈动脉超声作为功能性血流动力学监测的研究进展

Research Progress of Carotid Artery Doppler Ultrasound as a Means of Functional Hemodynamic Monitoring

准确判断容量状态及容量反应性是危重症患者液体治疗的关键。颈部多普勒超声作为新兴功能性血流动力学监测方法,因其即时、可重复性强的优点,逐渐受到重症医师的关注。本文从容量状态及容量反应性监测的必要性出发,概述颈总动脉校正血流时间和峰流速呼吸变异率的生理意义及临床应用价值。使无创颈总动脉超声参数判断容量反应性的方式能够在将来更好地应用于急诊室及重症监护室,从而减少导管相关血流感染及优化医疗资源管理。

Accurate determination of volume status and fluid responsiveness is the key to fluid therapy in critically ill patients. As an emerging method of functional hemodynamic monitoring, Carotid Dop-pler ultrasound has gradually attracted the attention of critical care physicians because of its ad-vantages of immediate and reproducibility. Starting from the necessity of volume status and fluid responsive monitoring, this paper summarizes the physiological significance and clinical applica-tion value of the carotid corrected flow time and respirophasic variation in carotid artery blood flow peak velocity. The method of determining fluid response by noninvasive carotid Doppler ultrasound can be better applied to emergency rooms and intensive care units in the future, thereby reducing invasive catheter related blood stream infection and optimizing the management of medical re-sources.