中心静脉压监测在重型颅脑损伤救治中的应用体会

Application of central venous pressure monitoring in the rescue of serious craniocerebral injury

目的探讨中心静脉压(CVP)在重型颅脑损伤患者的救治过程中的应用价值。方法回顾性分析109例重型颅脑损伤患者的CVP监测及临床资料。结果本组病例均未出现急性心衰、肺水肿,5例病人CVP值始终低于正常值,检查发现严重合并伤。根据出院时的GCS评分、意识情况和功能障碍程度,本组患者死亡19例(17.4%),无改善11例(10.1%),好转23(占21.1%),明显好转35例(32.1%),痊愈21例(19.3%)。结论CVP的监测,可了解有效循环血容量情况,科学可靠地指导输液及脱水降颅压治疗,有效提高重型颅脑损伤病人的抢救成功率。

Objective To study the value of central venous pressure（CVP） in the rescue of serious craniocerebral injury. Methods The data of CVP monitoring of 109 cases of serious craniocerebral injury were analyzed retrospectively. Results No one had acute heart failure or pulmonary edema.Five patients whose CVP was always lower than normal level and these patients had serious associated injury. According to the Glasgow Coma Scale （GCS）, condition of consciousness and degree of functional disturbance 19 cases died （17.4%）, 11 were not improved （ 10.1% ）, 23 were improved （21.1%）, 35 were improved obviously （32.1%）and 21 were cured （19.3%） during discharged from hospital. Conclusion CVP monitoring would understand effective circulating blood volume, guide the treatment of lowering intracranial pressure and increase the successful rescue rate of serious craniocerebral injury.