摘要
目的:探讨采用超声测量下腔静脉(IVC)横切面的内径及内径形变指数(SCI),预测老年患者全麻诱导后低血压的价值。方法:择期全麻手术老年患者105例,根据全麻诱导后血压结果分为低血压组和非低血压组。诱导前分别测量呼气末IVC横切面的长径(LD_(呼气))、短径(SD_(呼气))以及吸气末IVC横切面的长径(LD_(吸气))、短径(SD_(吸气)),并计算呼气末IVC内径形变指数(SCI_(呼气))和吸气末IVC内径形变指数(SCI_(吸气))。绘制受试者工作特征(ROC)曲线分析SCI预测低血压的价值。结果:最终纳入90例患者,37例(41%)发生麻醉诱导后低血压。低血压组SCI_(吸气)高于非低血压组(P<0.001),而SD_(吸气)小于非低血压组(P<0.001)。SCI_(吸气)预测全麻诱导后低血压的曲线下面积(AUC)为0.861,其灵敏度和特异度分别为86.49%、94.34%。SD_(吸气)预测全麻诱导后低血压的AUC为0.813,其灵敏度和特异度分别为72.97%、86.79%。结论:全麻诱导前超声测量SCI_(吸气)、SD_(吸气)可用于预测老年患者全麻诱导后低血压的发生。
Objective:To assess the value of shape change index(SCI)of internal diameter of inferior vena cava(IVC)measured on transverse section plane by ultrasonography in predicting hypotension in elderly patients following general anesthesia induction.Methods:105 elderly patients undergoing elective surgery were divided into hypotensive group and non-hypotensive group according to their blood pressure after anesthesia induction.IVC were measured by ultrasonography on transversal plane for the length diameter(LD_(expiration);LD_(inspiration))and short diameter(SD_(expiration);SD_(inspiration))at the end of inspiration and expiration,respectively before induction,and SCI of IVC at the end of expiration and inspiration(SCI_(expiration);SCI_(inspiration))was calculated.Then receiver operating characteristic(ROC)curve was drawn to analyze the value of SCI in predicting hypotension.Results:Of the 90 patients finally included,hypotension developed in 37(41%)after induction.SCI at inspiration was much higher than in hypotensive group than in non-hypotensive group(P<0.001),and SD at inspiration was significantly shorter in the non-hypotension group(P<0.001).The area under AUC curve of SCI_(inspiration) for predicting hypotension was 0.861,and its sensitivity and specificity were 86.49%and 94.34%,respectively.The AUC of SD_(inspiration) for predicting hypotension was 0.813,with sensitivity and specificity being respectively 72.97%and 86.79%.Conclusion:SCI and SD at the end of inspiration measured by ultrasonography can be used to predict the occurrence of hypotension in elderly patients after induction of general anesthesia.
作者
黄昌云
姚卫东
陈永权
曹亚
HUANG Changyun;YAO Weidong;CHEN Yongquan;CAO Ya(Department of Anesthesiology,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001,China)
出处
《皖南医学院学报》
CAS
2022年第3期267-270,共4页
Journal of Wannan Medical College
基金
皖南医学院中青年科研基金项目(WK2016F35)。
关键词
低血压
全身麻醉
下腔静脉
内径形变指数
hypotension
general anesthesia
inferior vena cava
shape change index
