山东大学学报(医学版) ›› 2014, Vol. 52 ›› Issue (10): 96-99.doi: 10.6040/j.issn.1671-7554.0.2014.278
朱雷, 赵志斌, 冯继英, 朱品, 栾恒飞, 张小宝
ZHU Lei, ZHAO Zhibin, FENG Jiying, ZHU Pin, LUAN Hengfei, ZHANG Xiaobao
摘要: 目的 探讨术前老年患者下腔静脉(IVC)及右心室(RV)直径的变化及其与中心静脉压(CVP)的关系,为快速无创判断术前老年患者的血容量提供参考依据。方法 选择40例术前禁食的老年患者(实验组)与30例术前未禁食的老年患者(对照组)。实验组患者入手术室后记录心率(HR)、血氧饱和度(SpO2)、平均动脉压(MAP),超声下测量IVC的最大值和最小值、RV的最大直径,计算下腔静脉呼吸衰减指数(IVC-CI),局麻下行中心静脉穿刺测量CVP。输入6%羟乙基淀粉8 mL/kg后再次测量并记录HR、SpO2、MAP、IVC、RV的数值及CVP的变化。对照组在同一时间段记录HR、SpO2、MAP、IVC、RV的数值(CVP除外),不给予液体治疗。结果 实验组呼气末的最大直径(IVCe)、吸气末的最小直径(IVCi)、RV均小于对照组(P<0.01)。实验组IVC-CI高于对照组(P<0.01)。液体治疗后IVC的最大直径升高46.5%,最小直径升高85.9%,并且与同期的CVP呈一定的正相关(r=0.598)。液体治疗后IVC-CI下降31.7%,与CVP呈负相关(r=-0.418)。结论 术前禁食的老年患者的IVC、RV、CVP均处于较低的水平,超声引导下测量IVC及RV能够反映术前老年患者的血容量水平,可为血容量治疗提供参考依据。
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