【摘 要】
：
目的 了解老年脓毒症休克患者下腔静脉管径和呼吸变异指数与中心静脉压(CVP)的关系,为床旁快速评估血容量提供依据. 方法 对急诊重症监护病房收治的28例老年脓毒症休克患者分
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目的 了解老年脓毒症休克患者下腔静脉管径和呼吸变异指数与中心静脉压(CVP)的关系,为床旁快速评估血容量提供依据. 方法 对急诊重症监护病房收治的28例老年脓毒症休克患者分别于液体复苏前、液体复苏2h及6h时床旁超声探测肝后下腔静脉管径并计算呼吸变异指数,同时记录CVP,并与对照组22例患者液体复苏前下腔静脉管径及呼吸变异指数进行比较,分析下腔静脉管径及呼吸变异指数与CVP的相关性；绘制受试者工作特征曲线(ROC)确定下腔静脉管径及呼吸变异指数预测CVP 8 mm Hg的界值. 结果 脓毒症休克组下腔静脉的最大径为(1.23±0.28)cm、最小径为(0.48±0.18)cm,下腔静脉呼吸变异指数为(55.88±11.18)％；对照组下腔静脉的最大径为(1.95±0.14)cm、最小径为(1.73±0.13)cm,下腔静脉呼吸变异指数为(11.23±1.82)％,老年脓毒症休克患者下腔静脉管径明显小于对照组(P＜0.01),呼吸变异指数明显高于对照组(P＜0.01)；脓毒症休克患者下腔静脉最大径、最小径与CVP呈正相关(r=0.668、0.863,均P＜0.01),呼吸变异指数与CVP呈负相关(r=-0.848,P＜0.01)；下腔静脉最大径、最小径及呼吸变异指数预测CVP 8 mm Hg的界值分别为1.56 cm(敏感度85.2％、特异度86.3％)、1.13 cm(敏感度96.3％、特异度94.1％)、30％(敏感度88.2％、特异度96.3％). 结论 床旁超声探测肝后下腔静脉可以在一定程度上预测CVP,为临床医师快速评估老年脓毒症休克患者血容量提供参考.
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