颈内静脉直径呼吸变异率指导容量治疗研究.docVIP

颈内静脉直径呼吸变异率指导容量治疗研究 　　[摘要] 目的 研究颈内静脉直径呼吸变异率指导容量治疗的可行性。 方法 选择符合纳入标准的重症患者共36例，分别应用超声记录容量干预前、干预后颈内静脉直径随呼吸的变化（即变异率）及应用PiCCO容量监测仪动态监测心排出量（CO）的变化，同时根据容量干预后心排出量上升≥15%和15%定义容量有、无反应，分析颈内静脉直径随呼吸变异率与容量反应性的关系。 结果 36例重症患者容量干预后其DIJVmax、DIJVmin、CO均较干预前显著增加，差异有统计学意义（P0.05）。其中容量有反应26例，DIJV=（63.78±14.32）%。容量无反应组6例，DIJV=（26.14±3.81）%， DIJV与容量反应性呈正相关（r=0.387，P0.05）。 结论 颈内静脉直径的呼吸变异率与容量反应性呈正相关，超声技术无创、便捷，应用超声技术测量颈内静脉直径呼吸变异率，从而指导容量治疗，有利于减少患者的痛苦及并发症的发生。 　　[关键词] 颈内静脉直径；呼吸变异率；容量治疗 　　[中图分类号] R322 [文献标识码] B [文章编号] 1673-9701（2015）01-0010-03 　　Study of internal jugular vein diameter respiratory variation rate of blood volume therapy 　　WANG Xiongxiong LV Zhigang CAI Yun HU Dongjun WANG Mingming 　　Department of ICU， Ningbo City Yinzhou District the Second Hospital， Ningbo 315192， China 　　[Abstract] Objective To study the feasibility of internal jugular veindiameter respiratory variation rate to volume therapy. Methods Chose a total of 36 cases severe patients， changed internal jugular vein diameter with breathing by ultrasound before and after the intervention were compared， the cardiac output（CO） change by application PiCCO volume monitor dynamic monitoring were compared， at the same time according to the capacity of intervention， cardiac outputincreased ≥ 15% and the definition of 15% capacity， internal jugular vein diameter increases with reactionrespiratory variability and capacity were compared. Results Thirty-six cases of severepatients after intervention capacity DIJVmax， DIJVmin， CO were significantly increased compared with before intervention， the difference was statistically significant （P0.05）. The capacity of areaction in 26 cases， DIJV=（63.78±14.32）%. Capacity of non response group 6 cases， DIJV=（26.14±3.81）%， DIJV and capacity reactive positive correlation（r=0.387， P0.05）. Conclusion The internal jugular vein respiratory variation of diameter ratio and wing weight reactive is related to ultrasonic technology， noninvasive， convenient， the ultrasonic measurement of carotid veno