中国实用护理杂志
中國實用護理雜誌
중국실용호리잡지
CHINESE JOURNAL OF PRACTICAL NURSING
2012年
11期
76-78
,共3页
侧卧位%中心静脉压%零点位置
側臥位%中心靜脈壓%零點位置
측와위%중심정맥압%영점위치
Lateral position%Central venous pressure%Zero point position
目的 通过测定45°、90°侧卧位中心静脉压(CVP)与平卧位CVP的差异,探讨侧卧位时CVP的零点位置.方法 择期需要气管插管全麻的手术患者50例,在同一时段先后分别采用不同体位(侧卧位与平卧位)测量CVP,然后侧卧位下移动传感器,标记CVP值与平卧位时值相同时传感器在胸壁上的位置,同时记录血压、心率、SpO2、呼吸的变化.结果 右侧45°、90°和左侧90°侧卧位时,与平卧位测出CVP差异明显,左侧45.时与平卧位CVP相比差异无统计学意义；右侧45.、9伊卧位时CVP平均分别增高1.18 mm Hg(1mm Hg=0.133 kPa)、1.32 mm Hg,左侧45.、90.卧位时CVP时平均下降0.34 mm Hg、0.85mm Hg;4种卧位零点分别位于右侧腋前线的左侧(0.8±0.4)cm、右侧胸骨缘线上方(0.8±0.2) cm、左侧腋前线右侧(0.3±0.2)cm、左侧胸骨缘线下方(2.2±0.3)cm.4种卧位时的MAP、心率、SpO2及呼吸频率与平卧位时的相应指标值比较差异无统计学意义.结论 通过研究侧卧位对CVP的影响,确定零点位置,不仅可方便CVP的临床监测,还可避免因患者监测CVP被迫或被动平卧位带来的不适与并发症.
目的 通過測定45°、90°側臥位中心靜脈壓(CVP)與平臥位CVP的差異,探討側臥位時CVP的零點位置.方法 擇期需要氣管插管全痳的手術患者50例,在同一時段先後分彆採用不同體位(側臥位與平臥位)測量CVP,然後側臥位下移動傳感器,標記CVP值與平臥位時值相同時傳感器在胸壁上的位置,同時記錄血壓、心率、SpO2、呼吸的變化.結果 右側45°、90°和左側90°側臥位時,與平臥位測齣CVP差異明顯,左側45.時與平臥位CVP相比差異無統計學意義；右側45.、9伊臥位時CVP平均分彆增高1.18 mm Hg(1mm Hg=0.133 kPa)、1.32 mm Hg,左側45.、90.臥位時CVP時平均下降0.34 mm Hg、0.85mm Hg;4種臥位零點分彆位于右側腋前線的左側(0.8±0.4)cm、右側胸骨緣線上方(0.8±0.2) cm、左側腋前線右側(0.3±0.2)cm、左側胸骨緣線下方(2.2±0.3)cm.4種臥位時的MAP、心率、SpO2及呼吸頻率與平臥位時的相應指標值比較差異無統計學意義.結論 通過研究側臥位對CVP的影響,確定零點位置,不僅可方便CVP的臨床鑑測,還可避免因患者鑑測CVP被迫或被動平臥位帶來的不適與併髮癥.
목적 통과측정45°、90°측와위중심정맥압(CVP)여평와위CVP적차이,탐토측와위시CVP적영점위치.방법 택기수요기관삽관전마적수술환자50례,재동일시단선후분별채용불동체위(측와위여평와위)측량CVP,연후측와위하이동전감기,표기CVP치여평와위시치상동시전감기재흉벽상적위치,동시기록혈압、심솔、SpO2、호흡적변화.결과 우측45°、90°화좌측90°측와위시,여평와위측출CVP차이명현,좌측45.시여평와위CVP상비차이무통계학의의；우측45.、9이와위시CVP평균분별증고1.18 mm Hg(1mm Hg=0.133 kPa)、1.32 mm Hg,좌측45.、90.와위시CVP시평균하강0.34 mm Hg、0.85mm Hg;4충와위영점분별위우우측액전선적좌측(0.8±0.4)cm、우측흉골연선상방(0.8±0.2) cm、좌측액전선우측(0.3±0.2)cm、좌측흉골연선하방(2.2±0.3)cm.4충와위시적MAP、심솔、SpO2급호흡빈솔여평와위시적상응지표치비교차이무통계학의의.결론 통과연구측와위대CVP적영향,학정영점위치,불부가방편CVP적림상감측,환가피면인환자감측CVP피박혹피동평와위대래적불괄여병발증.
Objective To discuss the zero point position of central venous pressure(CVP) by determining the difference of CVP under 45°,90°lateral position and supine position. Methods The CVP of 50 cases performed elective surgery undergoing tracheal intubation anesthesia were measured of lateral position and supine position at the same time,the position of the sensor in the chest wall was marked when the CVP values was the same in the two positions by means of moving the sensors,while changes of BP,HR,SpO2,RR were recorded. Results The CVP under right 45°,90° and left 90° lateral position were statistically significant than that under supine position,the CVP under left 45° lateral position was not significanfly different from that under supine position.The zero point under right 45°,90°and left 45°,90°lateral position situated at the left side of the right anterior axillary line (0.8 ± 0.4)cm,the upper side of the right sterna border line (0.8 ± 0.2)cm,the right side of the left anterior axillary line (0.3 ± 0.2)cm,the lower side of the left sternal border line (2.2 ± 0.3)cm. Conclusions The zero point position determined by monitoring the changes of CVP under lateral position can not only comfortably measure CVP but also avoid discomfort and complications in patients by forced supine position.
