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组织介电常数测量能否评估血液透析患者的循环血容量变化?

Can tissue dielectric constant measurements assess circulating blood volume changes in patients undergoing haemodialysis?

作者信息

Toyooka Ken-Taro, Niwa Hidetomo, Hashiba Eiji, Hirota Kazuyoshi

机构信息

Department of Anesthesiology, Hirosaki University Hospital, Hirosaki, Japan.

Division of Intensive Care Unit, Hirosaki University Hospital, Hirosaki, Japan.

出版信息

Clin Physiol Funct Imaging. 2018 May;38(3):497-501. doi: 10.1111/cpf.12446. Epub 2017 Jun 18.

Abstract

BACKGROUND

The tissue dielectric constant (TDC) method uses an open-ended coaxial probe to achieve non-invasive measurement of water content in skin. The aim of our study was to test the hypothesis that the changes in circulating blood volume would be associated with the changes in TDC values in patients undergoing haemodialysis.

METHODS

In this prospective descriptive study, TDC measurements were performed for three parts of the body (the face, shin and hand) before and after patients underwent haemodialysis (N = 83). The primary outcome measure was the correlation between the amount of water removal and ΔTDC at each body site measured (ΔTDC = posthaemodialysis TDC-prehaemodialysis TDC). The secondary outcome measure was the mean difference in TDC value before and after haemodialysis.

RESULTS

The TDC values measured at each part of the body were significantly reduced after haemodialysis, but the percentage difference between pre- haemodialysis and posthaemodialysis was small for the face, shin and hand, with %mean ± SE values of -4.4 ± 0.70, -3.2 ± 0.98 and -6.0 ± 1.6; 95 per cent confidence intervals (lower bound to upper bound) of 3.0-5.8, 1.3-5.2 and 2.7-9.2; and P values of P = 0.000, P = 0.000 and P = 0.000, respectively. The inverse correlation between ΔTDC and the amount of water removal was also weak (correlation at the face, r = -0.25, P = 0.028; at the shin, r = -0.26, P = 0.018; and at the hand, no significant correlation).

CONCLUSION

Our results indicate that TDC measurement can be used to assess the changes in local oedema, but may be unlikely to evaluate real-time changes in the circulating blood volume in a clinical setting.

摘要

背景

组织介电常数(TDC)方法使用开口同轴探头实现对皮肤含水量的无创测量。我们研究的目的是检验以下假设:接受血液透析的患者循环血容量的变化与TDC值的变化相关。

方法

在这项前瞻性描述性研究中,对83例患者进行血液透析前后身体三个部位(面部、胫骨和手部)的TDC测量。主要观察指标是每个测量身体部位的脱水量与TDC变化量之间的相关性(TDC变化量=血液透析后TDC-血液透析前TDC)。次要观察指标是血液透析前后TDC值的平均差异。

结果

血液透析后身体各部位测量的TDC值均显著降低,但面部、胫骨和手部血液透析前与血液透析后的百分比差异较小,平均±标准误值分别为-4.4±0.70、-3.2±0.98和-6.0±1.6;95%置信区间(下限至上限)分别为3.0-5.8、1.3-5.2和2.7-9.2;P值分别为P=0.000、P=0.000和P=0.000。TDC变化量与脱水量之间的负相关性也较弱(面部相关性,r=-0.25,P=0.028;胫骨相关性,r=-0.26,P=0.018;手部无显著相关性)。

结论

我们的结果表明,TDC测量可用于评估局部水肿的变化,但在临床环境中可能不太可能评估循环血容量的实时变化。

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