持续中心静脉压监测在神经重症患者中应用价值探讨

Application value of dynamic central venous pressure monitoring in neurocritical patients

目的探讨持续中心静脉压监测在神经重症患者中的应用价值。方法选择我科神经重症监护室持续中心静脉压监测患者与同期病人进行对照,比较2组间的一般资料,GCS评分,APACHE?Ⅱ评分,住院期间输液量、心衰发生率、肺部感染率及抗生素暴露时间、入住监护室时间、病死率等指标。结果通过持续中心静脉压监测指导下调整补液治疗,中心静脉压监测组发生心衰例数及肺部感染比例较对照组明显减少(P<0.05),入住监护室时间缩短,病死率有所下降,但差异无统计学意义(P>0.05)。结论对神经重症患者进行持续中心静脉压监测,可有效掌握患者的循环血容量变化情况,更好地指导临床治疗,从而有效降低相关并发症,改善预后。

Objective To explore the application value of dynamic central venous pressure monitoring in neurocritieal pa tients. Methods The patients treated with dynamic central venous pressure monitoring or not were selected and statistically compared in our department of Neurological Intensive Care Unit were compared. The general data,GCS score, APACHE H score,in fusion volume during hospitalization, the incidence of heart failure, the rate of lung infection and antibiotic exposure tirae, the time of admission to the ward,the mortality rate and other indicators were compared between the two groups. Results Central venous pressure monitoring group had decreased heart failure cases and the proportion of lung infection （P〈0.05）. The time of hospitali zation fatality rate had a decreasing trend, but there was no statistically significant difference （P 〉0.05）. Conclusion Dynamic central venous pressure monitoring in neurocritical patients can effectively control the change of circulating blood volume and guide the clinical treatment, thus effectively reduce the related complication and improve prognosis.