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| 下腔静脉塌陷指数与产妇腰麻后仰卧位低血压综合征的相关性 |
| Correlation between inferior vena cava collapse index and supine hypotension syndrome after spinal anesthesia |
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| DOI：10.12089/jca.2020.06.010 |
| 中文关键词: 超声 下腔静脉 塌陷指数 仰卧位低血压 |
| 英文关键词: Ultrasound Inferior vena cava Collapse index Supine hypotension |
| 基金项目:河南省科技厅产学研项目(182107000025) |
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| 中文摘要: |
目的 观察下腔静脉塌陷指数（IVC-CI）对产妇腰麻后仰卧位低血压综合征（SHS）的预测价值。
方法 随机选择行择期剖宫产手术的产妇58例，年龄20～35岁，ASAⅠ或Ⅱ级，根据是否发生SHS将产妇分为两组：发生SHS组（S组，n=35）和未发生SHS组（W组，n=23）。记录两组入室后平卧位（T0）、手术床左倾30°（T1）、腰麻后5 min（T2）、S组发生SHS（T3）时的HR、SBP、DBP。使用超声测量T0—T2时下腔静脉（IVC）内径的最大值（IVCmax）和最小值（IVCmin），计算IVC-CI=(IVCmax-IVCmin)/IVCmax。分析S组T0—T2时IVC-CI与T3时SBP的相关性。
结果 与T0时比较，T1时两组HR明显减慢（P＜0.05），SBP和DBP明显升高（P＜0.05）；T2时两组HR明显增快（P＜0.05），SBP和DBP明显降低（P＜0.05）。T0—T2时S组SBP和DBP明显低于W组（P＜0.05），IVCmax和IVCmin明显高于W组（P＜0.05）。T0时S组IVC-CI明显低于W组（P＜0.05），T1、T2时S组IVC-CI明显高于W组（P＜0.05）。S组T0（r=－0.37，P=0.03）、T1（r=-0.44，P=0.01）、T2（r=-0.38，P=0.03）时IVC-CI和T3时SBP呈明显线性负相关。ΔIVC-CI预测SHS的临界值为0.75%，敏感性为66.7%，特异性为80.0%。
结论 产妇体位变换前后超声测量下腔静脉塌陷指数能够预测仰卧位低血压综合征的发生。 |
| 英文摘要: |
Ojective To observe the predictive effect of the inferior vena cava collapse index (IVC-CI) on the supine hypotension syndrome (SHS) after spinal anesthesia.
Methods Fifty-eight patients undergoing elective cesarean section, aged 20-35 years, falling into ASA physical status Ⅰ or Ⅱ, were randomlydivided into supine hypotension syndrome group (group S, n = 35) and non-supine hypotension syndrome group (group W, n = 23) according to whether SHS oceurred or not. The HR, SBP, and DBP of the supine supine position (T0), leftward tilt of the operating table 30° (T1), spinal anesthesia 5 minutes (T2) and supine hypotension (T3) were recorded. The maximum value (IVCmax) and minimum value (IVCmin) of the diameter of the inferior vena cava at T0-T2 were measured using ultrasound, and the IVC-CI [ (IVCmax-IVCmin) / IVCmax] was calculated. The correlation between IVC-CI at T0-T2 and SBP at T3 were analyzed in group S.
Results Compared with T0, HR in the two groups decreased significantly at T1(P < 0.05), SBP and DBP increased significantly at T1(P < 0.05), and HR in the two groups increased significantly at T2(P < 0.05), while SBP and DBP decreased significantly at T2(P < 0.05). SBP and DBP in group S were significantly lower, IVCmax and IVCmin were significantly higher than those in group W at T0-T2(P < 0.05). IVC-CI in group S was significantly lower than that in group W at T0(P < 0.05). IVC-CI in group S were significantly higher than that in group W at T1 and T2(P < 0.05). There was an obvious negative linear correlation between SBP at T3 with IVC-CI at T0(r = -0.37， P = 0.03), T1(r = -0.44, P = 0.01), T2(r = -0.38, P = 0.03). The critical value of ΔIVC-CI to predict supine hypotension syndrome was 0.75 mm, the sensitivity was 66.7%, and the specificity was 80.0%.
Conclusion The IVC-CI can predict the occurrence of supine hypotension syndrome. |
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