重症脑出血血容量监测的早期临床意义

Monitoring blood volume in heavy intracerebral hemorrhage patients

目的探讨重症脑出血患者中心静脉压血容量监测的早期临床意义。方法选择232例基底节出血患者,根据是否进行了中心静脉压(CVP)监测分为两组。监测组105例,入院后立即行CVP监测,维持CVP6～12cmH2O;非监测组127例,入院后未行CVP监测。观察发病2周时多器官功能障碍综合征(MODS)发生率、总病死率的差异。结果监测组MODS发生率为19.05%(20/105)、总病死率为27.62%(29/105),明显低于非监测组的MODS发生率〔33.07%(42/127)〕和总病死率〔41.73%(53/127)〕。两组间MODS发生率和总病死率有显著性差异(P<0.05)。结论中心静脉压血容量监测可以明显降低重症脑出血患者的MODS发生率和总病死率,应成为重症脑出血患者补液治疗的常规监测手段。

Objective To evaluate the importance of monitoring the central venous pressure （CVP） in patients with heavy intracerebral hemorrhage in acute phase. Methods 232 patients with basal ganglia hemorrhage were recruited retrospectively in this study. All patients were divided into two groups： CVP monitoring group （n=105） and without monitoring CVP group （n=127）. The CVP was maintained as 6-12cm H2O in the monitoring group. The incidence of MODS and mortality of the two groups were investigated and compared. Results The mortality and incidence of MODS in patients with heavy intraeerebral hemorrhage were significant lower in monitoring group than in control group two weeks after the onset of the hemorrhage. Conclusions Blood volume management with CVP monitoring can markedly reduce the mortality and incidence of MODS in patients with heavy intracerebral hemorrhage so it may be a routine monitoring method in treating patients with heavy intracerebral hemorrhage.