【摘要】 目的:探讨拟行神经外科手术患者下腔静脉（IVC）直径的变化及其与每搏量指数（SVI）的关系,评价超声引导测量IVC直径预测患者容量反应的准确性。方法:30例术前禁食的准备行神经外科手术的患者,入手术室记录初始平均动脉压（MAP）、血氧饱和度（SPO₂）、心率（HR）、每搏量变异（SVV）以及每搏量指数（SVI）、超声引导下测量IVC的最大值和最小值（IVCmax,IVCmin）、计算下腔静脉的呼吸衰减指数（IVCCI）。经过液体治疗以后,测量并记录MAP、SPO₂、HR、SVV、SVI及IVC的数值。将SVI增加大于10%定义为容量反应性阳性。结果:30例患者经过液体复苏后,其IVC最大直径增加35.0%（P<0.01）,最小直径增加23.2%（P>0.01）,IVC-CI下降18.2%（P>0.01）,SVI增加18.5%（P<0.01）。IVCmax与同期的SVI呈正相关（P<0.01）,而IVCmin及IVC-CI与SVI则未出现显著相关（P>0.01）。结论:超声引导下测量IVC的最大直径可用于预测神经外科手术患者容量反应性及指导术中液体治疗,并为判断患者的容量水平提供一定的参考依据。更多还原

【Abstract】 Objective: To evaluate IVC diameters and explore the correlation of these findings with stroke volume index( SVI) for prediction of fluid responsiveness with ultrasound in patients undergoing neurosurgical surgery.Methods: Forty patients with preoperative fasting who scheduled for neurosurgical surgery were enrolled in the study. The maximum and minimum IVC diameters( IVCmax,IVCmin) was measured in hypovolemic patients with ultrasonography both before and after fluid resuscitation. SVI > 10% was defined as fluid responsiveness positive.Results: Thirty patients underwent IVC sonographic measurements and SVI calculation. After fluid resuscitation,there was a significant increase in the mean diameters of the IVCmax and SVI in these patients( P < 0. 01). The correlation coefficient between the IVCmax and the percentage increase in SVI after an intravenous fluid was 0. 89.IVCmin and IVC-CI had no significant correlation with SVI. Conclusion: Ultrasonographic measurements of IVC diameters could be a useful noninvasive tool for the prediction of fluid responsiveness in patients undergoing neurosurgical surgery.更多还原