| Object:To monitor and analyze changes of the inferior vena cava diameter in trauma patients with hemorrhagic shock by bedside ultrasound to guide the diagnosis and treatment of shock.Methods:Selected patients with traumatic hemorrhagic shock and trauma patients without shock in the emergency department of our hospital from August 2019 to October 2020 as two control groups,and collected their general data.Using the bedside ultrasound instrument to measure and record the diameter of the inferior vena cava before and after treatment in patients with traumatic hemorrhagic shock and in patients without trauma,and calculate the shock index and the shape change index(SCI)of the inferior vena cava based on the results obtained in trauma patients.The enumeration data used chi-square test,and the measurement data used independent sample t-test to analyze the difference of the two groups of patients.Paired sample t-test was used to analyze the diameter indexes of the inferior vena cava in the patients with traumatic hemorrhagic shock from before and after the shock was corrected.Pearson correlation coefficient analyzes the correlation between the inferior vena cava diameter index,shock index and central venous pressure.ROC curve and Delong test are used to analyze and compare the predictive power of each index of the inferior vena cava diameter when trauma patients have hemorrhagic shock.Results:A total of 100 trauma patients meeting the criteria were screened,including 50 patients with traumatic hemorrhagic shock and 50 trauma patients without hemorrhagic shock.There was no significant difference in ordinary data between the two groups of trauma patients(P< 0.05).There is no statistical difference between the trauma patients and the healed traumatic hemorrhagic shock patients on IVCmax,IVCmin and SCI(P>0.05).The maximum diameter of the inferior vena cava(IVCmax)and the minimum diameter of the inferior vena cava(IVCmin)were higher than those in the shock group,the shock index and the SCI of the inferior vena cava were lower than those in the shock group.When trauma patients with hemorrhagic shock,IVCmax and IVCmin are positively correlated with central venous pressure(CVP),SCI and CVP are negatively correlated.After treatment,IVCmax and SCI are negatively correlated with CVP,the correlation between IVCmax and CVP is weak,IVCmin and CVP are positively correlated.SCI and IVCmin are superior to IVCmax in the predictive ability of hemorrhagic shock occurring in trauma;the optimal bound when taking the maximum Jorden index is: IVCmax≤2.03 cm,IVCmin≤1.28 cm,SCI≥1.41.Conclusion:The data of IVCmax,IVCmin and SCI obtained by bedside ultrasound have some clinical guidance value in the diagnosis and treatment of traumatic hemorrhagic shock. |
