| 摘要: |
| ［摘要］ 目的 探讨下腔静脉塌陷指数（IVC-CI）在指导早产儿肺出血液体治疗中的应用价值。方法 选择2016年7月至2020年6月厦门市儿童医院收治的肺出血的早产儿46例，其中22例接受床旁测量IVC-CI（观察组），24例未接受床旁测量IVC-CI（对照组）。在常规治疗（包括机械通气、止血等）基础上，观察组结合IVC-CI动态评估容量状况，指导液体治疗；对照组予经验性液体治疗。比较两组观察时段内患儿液体入量及乳酸、氧合指数改善时间。结果 Pearson相关性分析结果显示，观察组IVC-CI与Hb下降程度呈正相关（r=0.859，P=0.000)。在发现肺出血后0 h～5 h 59 min，观察组液体输入量高于于对照组，而在6 h～23 h 59 min的液体输入量低于对照组，差异有统计学意义（P<0.05）；在24～48 h，两组液体输入量差异无统计学意义（P>0.05）。观察组乳酸恢复正常及氧合指数下降50%时间均快于对照组，差异有统计学意义（P<0.05）。观察组呼吸机治疗时间短于对组组，差异有统计学意义［（127.27±34.18）h vs （154.08±45.45）h；t=2.245，P=0.003］。结论 超声指导下检测IVC-CI能动态评估容量状态，针对性地指导早产儿肺出血液体治疗，有助于病情恢复。 |
| 关键词: 下腔静脉塌陷指数 早产儿 肺出血 液体治疗 |
| DOI：10.3969/j.issn.1674-3806.2022.06.11 |
| 分类号:R 722.6 |
| 基金项目:厦门市医疗卫生指导项目（编号：3502Z20209218） |
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| Application value of inferior vena cava collapsibility index in guiding fluid therapy for pulmonary hemorrhage in preterm infants |
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JIN Hong-juan, LIU Xiao-yan, HUANG Ying
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Department of Neonatology, Children′s Hospital of Fudan University at Xiamen(Xiamen Children′s Hospital), Xiamen Neonatal Medical Service Quality Control Center, Fujian 361000, China
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| Abstract: |
| ［Abstract］ Objective To investigate the application value of inferior vena cava collapsibility index(IVC-CI) in guiding fluid therapy for pulmonary hemorrhage in preterm infants. Methods Forty-six preterm infants with pulmonary hemorrhage who were admitted to Xiamen Children′s Hospital from July 2016 to June 2020 were selected. Among the 46 preterm infants, 22 cases received bedside measurement of IVC-CI(the observation group), and the other 24 cases did not receive bedside measurement of IVC-CI(the control group). On the basis of routine treatments(including mechanical ventilation and haemostasis), the observation group was combined with IVC-CI dynamic assessment to evaluate the volume status for guiding fluid therapy; the control group was given empirical fluid therapy. The fluid intake and the improvement time of lactic acid and oxygenation index were compared between the two groups during the observation period. Results The results of Pearson correlation analysis showed that IVC-CI was positively correlated with the declined degree of Hb in the observation group(r=0.859, P=0.000). The fluid intake of the observation group was higher than that of the control group during the period from 0 hours to 5 hours and 59 minutes after the discovery of pulmonary hemorrhage, while the fluid intake of the observation group was lower than that of the control group from 6 hours to 23 hours and 59 minutes after the discovery of pulmonary hemorrhage, and the differences were statistically significant between the two groups(P<0.05). There was no significant difference in fluid intake between the two groups from 24 hours to 48 hours(P>0.05). The time when lactic acid returned to normal and oxygenation index decreased by 50% in the observation group was shorter than that in the control group, and the difference was statistically significant(P<0.05). The duration of ventilator treatment in the observation group was shorter than that in the control group, and the difference was statistically significant ［(127.27±34.18)h vs (154.08 ±45.45)h; t=2.245, P=0.003］. Conclusion The measurement of IVC-CI under the guidance of ultrasound can dynamically assess the volume status, and guide the fluid therapy of preterm infants with pulmonary hemorrhage in a targeted manner, and contribute to the recovery of the disease. |
| Key words: Inferior vena cava collapsibility index(IVC-CI) Preterm infant Pulmonary hemorrhage Fluid therapy |
