机械通气病人中心静脉压测量方法的探讨

Probe into methods on measurement of central venous pressure in patients undergoing mechanical ventilation

[目的 ]探讨机械通气状态下准确、方便测量中心静脉压 (CVP)的方法。 [方法 ]对 2 0 6例机械通气病人进行脱机前后CVP测量 ,将所得数据进行直线相关分析 ,检验脱机前后CVP值的相关性。 [结果 ]用呼气末正压 (PEEP )、压力支持(PSV ) +PEEP的病人 ,脱机前与脱机后的CVP呈直线正相关关系 (r =0 .93 7,P <0 .0 1) ,直线回归方程为 <y =0 .86x -1.3 3 ;用控制通气 (CV )、辅助控制通气(A -CV)的病人 ,脱机前与脱机后的CVP也呈直线正相关关系 (r =0 .978,P <0 .0 1) ,直线回归方程为 <y =0 .98x -1.2 7。 [结论 ]不同的通气模式对CVP的影响程度不同 ,故为机械通气状态下病人测量CVP时 ,应根据具体的通气模式 ,将机械通气时测得的CVP值代入相应的回归方程来预测脱机后的CVP值。

Objective: to explore an accurate, convenient way to measure central venous pressure (CVP) for patients undergoing mechanical ventilation. Method: a total of 206 patients accepting mechanical ventilation were selected and their CVP were measured before and after detaching ventilator. CVP values of patients were analyzed the correlation of CVP before and after ventilator detaching via linear correlative analysis. Result: the positive straight correlation existed not only in patients undergoing either PEEP or PSV+PEEP ventilation (r=0.937,P<0.01).The linear regression equation is [HT7”,5”SS]<y=0.86x-1.33. However, CVP values of patients underwent CV or A-CV before and after ventilator detaching also showed positive straight correlation(r=0.978,P<0.01),and the linear regression equation is [HT7”,5”SS]<y=0.98x-1.27. Conclusion: it showed that different ventilation modes have influence on CVP value to different extents. So when measuring CVP of patients undergoing mechanical ventilation, one should take CVP values tested during ventilation into corresponding regression equation to predict the CVP value after detaching ventilator based on their specific ventilation mode.