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机械通气患者中心静脉压与上腔静脉横径相关性研究
Correlation between Central Venous Pressure and Superior Vena Cava Diameter of the Patients Undergoing Mechanical Ventilation
【作者】 林慧艳；
【导师】 辛苏宁；
【作者基本信息】 青岛大学 ， 内科学， 2007， 硕士
【摘要】 目的:通过监测机械通气病人中心静脉压（central venous pressure CVP）与上腔静脉横径值（superior vena cava diameter SVCD）的动态变化,来评价呼气末正压（positive end-expiratory pressure PEEP）对机械通气病人CVP与SVCD的影响,以及SVCD与CVP相关性研究。为用无创手段测定机械通气病人SVCD值以来指导患者液体治疗提供理论依据。方法:选取22例因急性呼吸衰竭行机械通气的病人作为研究组,男14例,女8例,应用彩色超声诊断仪监测受试者在不同水平PEEP（0-20cmH20）时的SVCD值与CVP值,同时记录患者心率、平均动脉压与血氧饱和度。统计学处理所有计量资料以及SVCD、CVP与PEEP相关性分析,P＜0.05为差别有统计学意义,P＜0.01为差别有显著性统计学意义。结果:（1）机械通气病人SVCD值随PEEP值的增加而递减,SVCD与PEEP值呈显著负相关（r=-0.981,P＜0.01）。（2）CVP与PEEP呈显著正相关（r=0.997,P＜0.01）。（3）CVP与SVCD值呈显著负相关,（r=-0.961,P＜0.01）。（4）PEEP与MAP、HR无相关性。（5）PEEP与SaO2值呈显著正相关,（r=0.971,P＜0.01）。结论:机械通气时患者SVCD值随PEEP值增加而减少,CVP随PEEP值增加而增加,从而可用多普勒超声心动图检查来监测SVCD值以来间接评价病人液体治疗效果。
【Abstract】 OBJECTIVE:To evaluate the effect of positive end-expiratory pressure（PEEP） on central venous pressure（CVP） and superior vena cava diameter（SVCD） of the patients undergoing mechanical ventilation in dynamic diversify,and to find the correlation between CVP and SVCD.To verify the theory of monitoring CVP with non-invasive method.METHODS:22 patients（14 male and 8 female）undergoing mechanical ventilation for acute respiratory failure were enrolled in the study,and SVCD was measured by Doppler ultrasonography. SVCD,CVP,heart rate（HR）,mean arterial pressure（MAP） and oxygen saturation of arterial blood （SaO2） at various PEEP levels were recorded.Data were processed by F test and correlation analysis. There was statistical difference when P＜0.05 and significant statistical difference when P＜0.01.RESULTS:（1） There were decreases of SVCD accompanied with PEEP increment,and there was a significant negative correlation between SVCD and PEEP（r=-0.981,P＜0.01）.（2） There were increases of CVP accompanied with PEEP increment,and there was a significant positive correlation between CVP and PEEP（r=0.997,P＜0.01）.（3） There was a significant negative correlation between CVP and SVCD（r=-0.961,P＜0.01）.（4） No significant effects of PEEP on HR and MAP were found. （5）There was a significant positive correlation between SVCD and SaO2（r=-0.971,P＜0.01）.CONCLUSION:Monitoring SVCD by Doppler ultrasonography was an effective method directing fluid theraphy in patients undergoing mechanical ventilation.