关键词: 床旁超声, 下腔静脉直径, 下腔静脉扩张指数, 容量反应性

Abstract: This paper investigated the relationship and significance between bedside ultrasound inferior vena cava diameter (IVCD), distensibility index of the inferior vena cava (dIVC) and fluid volume responsiveness in septic shock. 140 patients with septic shock were selected and treated with fluid therapy, and then the clinical data of patients with positive and negative volume reaction were analyzed. The end inspiratory IVCD and end expiratory IVCD in patients with positive volume response were significantly lower than those in patients with negative volume response (P<0.05). There was a positive correlation between end inspiratory IVCD, end expiratory IVCD and stroke volume (SV) (P<0.05), and the dIVC was negatively correlated with SV (P<0.05). Logistic regression analysis showed that end inspiratory IVCD, end expiratory IVCD and dIVC were the influencing factors of positive volume response (P<0.05). The area under the ROC curve of positive volume response predicted by dIVC was 0.924, which was significantly higher than that of IVCD at the end of inspiration (0.789) and expiration (0.837), (P<0.05). Bedside ultrasound has a good application value in the treatment of septic shock fluid infusion. The IVCD and dIVC are the influencing factors of volume response, and dIVC has a higher value in predicting volume response.

Key words: bedside ultrasound, inferior vena cava diameter, distensibility index of the inferior vena cava, volume responsiveness