下腔静脉塌陷指数作为脊柱介入治疗期间评估患者血管状态的无创方法

Mykhailo Ivachevskij, Andriy Rusyn, Vitalina Ivachevska
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摘要

目的证明利用超声波评估下腔静脉塌陷指数对术后患者的血管状态进行无创诊断的可能性。方法。研究对象包括 67 名接受脊柱经椎板固定术和椎板切除术的患者。通过两种方法确定所有参与者的血管状态:中心静脉导管检查和中心静脉压测定,以及下腔静脉超声检查和下腔静脉塌陷指数计算。结果。根据有创中心静脉压评估结果,将患者分为三组:第一组(低血容量状态患者,31 人)、第二组(无血容量状态患者,25 人)和第三组(高血容量状态患者,11 人)。这些组别患者的中心静脉压指标平均值在统计学上有显著差异(P < 0.01)。各组下腔静脉塌陷指数平均值之间的差异具有统计学意义(P < 0.01)。下腔静脉塌陷指数指标与中心静脉压之间存在可靠的高度反相关性(P < 0.05)。结论确定患者的血容量状态是正确选择液体容量管理的一个极其重要的工具。超声波评估血管状态有许多优点,如该方法无创、广泛可用、价格低廉和执行速度快。我们的研究结果表明,使用下腔静脉塌陷度指数来评估患者的血管状态是可行的。
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INFERIOR VENA CAVA COLLAPSIBILITY INDEX AS A NON-INVASIVE METHOD OF ASSESSING THE VOLEMIC STATUS OF PATIENTS DURING SPINE INTERVENTIONS
Objective. To prove the possibility of using non-invasive diagnostics of the volemic state of postoperative patients using ultrasound assessment of inferior vena cava collapsibility index. Methods. The study included 67 patients who underwent transpedicular fixation of the spine with laminectomy. Volemiс status was determined for all participants in two ways: by catheterization of the central vein and determination of central venous pressure, as well as by ultrasound examination of the inferior vena cava and calculation of inferior vena cava collapsibility index. Results. According to the results of the invasive assessment of central venous pressure, patients were divided into 3 groups: group I (patients in hypovolemic state, n = 31), group II (patients in euvolemic state, n = 25) and group III (patients in hypervolemic state, n = 11 ). The average values of central venous pressure indicators in patients of these groups were statistically significantly different from each other (p < 0.01). The difference between the mean values of the inferior vena cava collapse index in the respective groups was statistically significant (p < 0.01). A reliable inverse correlation of very high strength was found between the indicators of inferior vena cava collapsibility index and central venous pressure (p < 0.05). Conclusions. Determination of the patient's volemic state is an extremely important tool for the correct selection of the fluid volume management. Ultrasound assessment of volemic status has a number of advantages, such as the non-invasiveness of the method, wide availability, low price and speed of execution. According to the results of our study, the possibility of using inferior vena cava collapsibility index to assess the volemic status of patients has been demonstrated.
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