Nixon Garry, Blattner Katharina, Finnie Wendy, Lawrenson Ross, Kerse Ngaire
Department of GP and Rural Health, University of Otago, Dunedin, New Zealand.
Medical Research Centre, University of Waikato and Waikato District Health Board, Hamilton, New Zealand.
Can J Rural Med. 2019 Oct-Dec;24(4):109-114. doi: 10.4103/CJRM.CJRM_26_18.
Measuring the diameter of the inferior vena cava (IVC) or the height of the jugular venous pressure (JVP) with point-of-care ultrasound (POCUS) is a practical alternative method for estimating a patient's intravascular volume in the rural setting. This study aims to determine whether or not POCUS of the IVC or JVP generates additional useful clinical information over and above routine physical examination in this context.
Twenty generalist physicians, working in five New Zealand rural hospitals, recorded their estimation of a patient's intravascular volume based on physical examination and then again after performing POCUS of the IVC or JVP, using a visual scale from 1 to 11.
Data were available for 150 assessments. There was an only moderate agreement between the pre- and post-test findings (Spearman's correlation coefficient = 0.46). In 28% (42/150) of cases, the difference was four or more points on the scale, and therefore, had the potential to be clinically significant.
In the rural context, POCUS provides new information that frequently alters the clinician's estimation of a patient's intravascular volume.
使用床旁超声（POCUS）测量下腔静脉（IVC）直径或颈静脉压（JVP）高度，是在农村地区估计患者血管内容量的一种实用替代方法。本研究旨在确定在此背景下，IVC或JVP的POCUS检查能否在常规体格检查之外提供更多有用的临床信息。
在新西兰五家农村医院工作的20名全科医生，先根据体格检查对患者的血管内容量进行评估，然后在对IVC或JVP进行POCUS检查后，再次使用1至11的视觉量表进行评估。
共获得150次评估的数据。测试前和测试后的结果之间只有中等程度的一致性（斯皮尔曼相关系数 = 0.46）。在28%（42/150）的病例中，差异在量表上为4分或更多，因此有可能具有临床意义。
在农村地区，POCUS提供了新的信息，这些信息经常会改变临床医生对患者血管内容量的估计。
