摘要
目的研究重症超声评估二尖瓣环收缩期运动峰值速度(Sm)在静脉-动脉体外膜肺氧合(VA-ECMO)撤机前的应用价值。方法选取2019年2月至2023年2月在宁夏医科大学总医院接受VA-ECMO治疗的患者40例,均行撤机试验,A组为撤机试验成功者(n=28),B组为撤机试验失败者(n=12)。在撤机试验前,应用重症超声监测患者的Sm、左室射血分数(left ventricular ejection fraction,LVEF)、左心室舒张末期内径(left ventricular end diastolic dimension,LVEDD),并对两组数据进行统计学分析。将撤机成功与否作为结局变量,将两组间存在有统计学差异的超声参数作为观察变量,进行VA-ECMO撤机试验成功与否的ROC曲线分析。结果A组撤机试验前Sm大于B组,差异均有统计学意义(均P<0.05);两组患者撤机试验前LVEDD比较差异无统计学意义(P>0.05)。Sm、LVEF的AUC分别为0.896、0.479,其中Sm有统计学意义(均P<0.05),Sm、EF的最佳临界值分别为0.821、0.321。结论重症超声评估Sm对VA-ECMO患者成功撤机具有重要的指导意义。
Objective To investigate the application of critical ultrasound in evaluating the systolic movement(Sm)peak velocity of mitral annula before weaning vein artery extracorporeal membrane oxygenation(VAECMO).Methods The weaning test was conducted in 40 patients who received VA-ECMO treatment in General Hospital of Ningxia Medical University from February 2019 to February 2023.There were 28 cases having successfully weaning VA-ECMO(group A)and 12 cases failing to wean(group B).Before weaning test,Sm,left ventricular ejection fraction(LVEF),and left ventricular end diastolic diameter(LVEDD)were measured by critical ultrasonography,and the data of two group were analyzed compared.The predicting values of Sm measured by critical ultrasonography for successful weaning were evaluated with ROC curve.Results Before the weaning test,the Sm of group A were higher than those of group B(P<0.05).While there was no significant difference in LVEDD between the two groups before weaning test(P>0.05).The area under ROC curve(AUC)of Tei index,Sm and LVEF were 0.896,0.479,respectively.The difference of Sm was statistically significant between two groups(all P<0.05),and the optimal cut-off values were 0.821 and 0.321,respectively.Conclusion Critical ultrasound evaluation of Sm can be used to predict successful weaning of VA-ECMO in ICU patients.
作者
杨慧燕
黄生奇
王静
方圆
顾继伟
YANG Huiyan;HUANG Shengqi;WANG Jing;FANG Yuan;GU Jiwei(General Hospital of Ningxia Medical University,Department of Cardiovascular Surgery,Yinchuan 750001,China;Yongning People's Hospital of Ningxia,Department of Traditional Chinese Medicine,Yongning 750004,China;不详)
出处
《实用医学杂志》
CAS
北大核心
2023年第14期1830-1834,共5页
The Journal of Practical Medicine
基金
宁夏自然科学基金项目(编号:2021AAC03334)。
关键词
超声
体外膜肺氧合
左心功能
二尖瓣环收缩期运动峰值速度
ultrasound
extracorporeal membrane oxygenation
left ventricular function
the systolic movement(Sm)peak velocity of mitral annula
作者简介
通信作者:顾继伟,E-mail:gujiwei1978@163.com。
