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    李敏, 刘成产, 褚明永. 床旁超声测定颈内静脉/颈总动脉截面积比值对重症病人容量反应性的评估价值[J]. 蚌埠医科大学学报, 2020, 45(8): 1104-1106. DOI: 10.13898/j.cnki.issn.1000-2200.2020.08.030
    引用本文: 李敏, 刘成产, 褚明永. 床旁超声测定颈内静脉/颈总动脉截面积比值对重症病人容量反应性的评估价值[J]. 蚌埠医科大学学报, 2020, 45(8): 1104-1106. DOI: 10.13898/j.cnki.issn.1000-2200.2020.08.030
    shu
    LI Min, LIU Cheng-chan, CHU Ming-yong. Value of the ratio of internal jugular vein to common carotid artery cross-sectional area measured by bedside ultrasound in the evaluation of volume responsiveness in critical patients[J]. Journal of Bengbu Medical University, 2020, 45(8): 1104-1106. DOI: 10.13898/j.cnki.issn.1000-2200.2020.08.030
    Citation: LI Min, LIU Cheng-chan, CHU Ming-yong. Value of the ratio of internal jugular vein to common carotid artery cross-sectional area measured by bedside ultrasound in the evaluation of volume responsiveness in critical patients[J]. Journal of Bengbu Medical University, 2020, 45(8): 1104-1106. DOI: 10.13898/j.cnki.issn.1000-2200.2020.08.030
    shu

    床旁超声测定颈内静脉/颈总动脉截面积比值对重症病人容量反应性的评估价值

    Value of the ratio of internal jugular vein to common carotid artery cross-sectional area measured by bedside ultrasound in the evaluation of volume responsiveness in critical patients

      摘要
    • 摘要:
      目的 探讨床旁超声测定颈内静脉（IJV）/颈总动脉（CCA）截面积比值对重症病人容量反应性的评估价值。
      方法 以50例重症病人为研究对象，按照被动抬腿（PLR）试验后心输出量变化（ΔCO）将病人分为容量反应阴性组（ΔCO < 15%，n=20）与容量反应阳性组（ΔCO≥15%，n=30）。采用床旁超声测量2组病人的IJV与CCA直径、截面积，计算IJV/CCA截面积比值，分析IJV/CCA截面积与PLR试验后ΔCO值的相关性；应用ROC曲线评价IJV/CCA截面积比值与ΔCO值预测容量反应性的准确性和阈值。
      结果 IJV的直径（14.03±4.877）mm、截面积（100.40±60.91）mm2与ΔCO值均存在负相关关系（P < 0.05）；CCA的直径（8.35±1.60）mm、截面积（57.64±18.50）mm2与ΔCO值无相关性（P>0.05）；容量反应阳性组的IJV/CCA截面积比值小于容量反应阴性组（P < 0.01）；IJV/CCA截面积比值与ΔCO值存在负相关关系（P < 0.01）；IJV/CCA截面积比值为1.66时的敏感度为87.1%，特异度为79.6%，ROC曲线下面积为0.836（95%CI：0.710~0.952）。
      结论 床旁超声测定IJV/CCA截面积比值是一种无创、便捷、可靠的评估重症病人容量反应性的方法。

       

      Abstract:
      Objective To discuss the value of the ratio of internal jugular vein(IJV) to common carotid artery(CCA) cross-sectional area measured by bedside ultrasound in the evaluation of volume responsiveness in critical patients.
      Methods Fifty critical patients were divided into the negative volume response group(ΔCO < 15%, n=20) and positive volume response group(ΔCO≥15%, n=30) according to the cardiac output change(ΔCO) after passive leg lift (PLR) test.The diameter and cross-sectional area of IJV and CCA in two groups were measured by bedside ultrasound, and the ratio of IJV to CCA cross-sectional area was calculated, and the correlation between IJV/CCA cross-sectional area ratio and ΔCO after PLR test was analyzed.The accuracy and threshold of the ratio of IJV/CCA cross-sectional area and ΔCO value in predicting the volumetric reactivity were evaluated by ROC curve.
      Results The diameter and cross-sectional area of IJV(14.03±4.877)mm and (100.40±60.91)mm2 were negatively correlated with the ΔCO value(P < 0.05), and the diameter and cross-sectional area of CCA(8.35±1.60)mm and (57.64±18.50)mm2 were not correlated with the ΔCO value(P>0.05).The ratio of IJV/CCA cross-sectional area in positive volume response group was significantly less than that in negative volume response group(P < 0.01), and the ratio of IJV/CCA cross-sectional area was negatively correlated with the ΔCO value(P < 0.01).At the IJV/CCA cross-sectional area ratio of 1.66, the sensitivity and specificity was 87.1% and 79.6%, respectively, and the areas under the ROC curve was 0.836(95%CI:0.710-0.952).
      Conclusions The bedside ultrasound measuring the ratio of IJV/CCA cross-sectional area is a noninvasive, convenient and reliable method to evaluate the volume responsiveness of critical patients.

       

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