Value of ultrasonic inferior vena cava parameters in predicting cesarean section subarachnoid obstruction and supine hypotension syndrome / 中国医师杂志

ABSTRACT

Objective:To explore the clinical value of ultrasonic inferior vena cava parameters in predicting supine hypotension syndrome after subarachnoid block.Methods:80 cases of cesarean section under subarachnoid block in singleton pregnancy treated in Beijing Maternity Hospital from August 2019 to March 2020 were selected retrospectively. According to the occurrence of supine hypotension syndrome after anesthesia, they were divided into two groups (group A had supine hypotension syndrome and group B did not), with 40 cases in each group. The changes of related parameters of inferior vena cava in supine position and left 30 ° lying position were compared between the two groups. The correlation between the maximum end expiratory diameter (IVCe), the minimum end inspiratory diameter (IVCi) and the collapse index (IVC-CI) of inferior vena cava and the changes of systolic blood pressure in supine hypotension syndrome were analyzed, and the value of IVCe, IVCi and IVC-CI in predicting supine hypotension syndrome were compared.Results:Under the condition of supine position and left 30 ° lying position, the levels of IVCe and IVCi in group A were significantly lower than those in group B ( P<0.05), and the levels of IVC-CI were higher than those in group B ( P<0.05). Spearman analysis showed that the levels of IVCe and IVCi were positively correlated with the changes of systolic blood pressure in the occurrence of supine hypotension syndrome ( P<0.05), and the levels of IVC-CI were negatively correlated with the changes of systolic blood pressure in the occurrence of supine hypotension syndrome ( P<0.05). IVC-CI had the highest yoden index and the highest sensitivity in predicting the occurrence of supine hypotension syndrome, and IVCe had the highest specificity in predicting the occurrence of supine hypotension syndrome. Conclusions:Cava collapse index has high sensitivity to predict supine hypotension syndrome, while the maximum end-expiratory diameter of inferior vena cava has high specificity to predict supine hypotension syndrome.