摘要
目的探讨呼气末正压（PEEP）对机械通气患者中心静脉压（CVP）、下腔静脉最大径、最小径及呼吸变异率的影响，并比较CVP与下腔静脉最大径、最小径及呼吸变异率之间的相关性。方法选择有创机械通气并监测中心静脉压的患者22例，观察患者PEEP0、2、4、6、8、10、12、14、16、18、20cmH20共11个水平条件下CVP、下腔静脉最大径、最小径的变化。结果随着PEEP水平的增加，CVP也逐渐增加，且各组间比较，差异均有统计学意义（F=65．32，P〈0．05）；下腔静脉最大径、下腔静脉最小径随着PEEP的增加而增加，并与CVP呈正相关（r=0．71，P〈0．05；r=0．64，P〈0．05）；下腔静脉呼吸变异率与CVP呈负相关（r=-0．22，P〈0．05）。结论CVP与下腔静脉管径最大值、最小值随着PEEP水平的增加而升高，下腔静脉呼吸变异率随PEEP的增加而变小，无创性监测下腔静脉管径及呼吸变异率与CVP同样可以作为评估患者右心前负荷的可靠指标。
Objective To explore the influence of positive end-expiratory pressure （PEEP） on central venous pressure （CVP）, radius of inferior vena cava （IVC） and respiration variation, and analyze the correlation between CVP and radius and respiration variation of IVC. Methods 22 mechanically ventilated patients were observed and measured for the radius of IVC and CVP in PEEP at 0, 2, 4, 6, 8, 10, 12, 14, 16, 18 and 20 cmH20, respectively. Results CVP elevated as PEEP increased and comparison among groups had statistical significance （F=65.32, P〈 0.05）. Maximum and minimum radius of IVC enlarged as PEEP increased and correlated with CYP （r=0.71, P〈0.05; r=0.64, P〈0.05）. Respiration variation of IVC correlated with CVP （r=-0.22, P〈0.05）. Conclusion CVP and radius of IVC increased as PEEP increased, and respiration variation of IVC reduced as PEEP increased. Radius and respiration variation of IVC were reliable indicator as CVP to assess the preload of right heart.
出处
《中国急救复苏与灾害医学杂志》
2012年第8期728-731,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
