临床医学
臨床醫學
림상의학
CLINICAL MEDICINE
2009年
5期
7-8
,共2页
中心静脉压%急性右室心肌梗死%低血压休克%扩容治疗
中心靜脈壓%急性右室心肌梗死%低血壓休剋%擴容治療
중심정맥압%급성우실심기경사%저혈압휴극%확용치료
Central venous pressure%Acute right ventricle myocardial infarction%Hypotension and shock%Expand the volume of circulating blood
目的 探讨急性右室心肌梗死扩容治疗时中心静脉压(CVP)应维持的最佳范围.方法 将68例急性右室心肌梗死并低血压休克患者采用随机对照的原则分为3组(A组、B组、C组),3组均予相同的基础治疗,如休息、吸氧、镇静、止痛、抗凝、抗血小板及再灌注治疗,在此治疗的基础上给予扩容治疗,使A组患者CVP维持在6～12 cm H2O,B组患者CVP维持在13～19 cm H2O,C组患者CVP维持在20～26 cm H2O,监测患者的心率、平均动脉压、心输出量、尿量及肺水肿发生率,比较各组疗效.另分别计算出单纯右室心肌梗死与非单纯右室心肌梗死患者的CVP值并进行比较.结果 B组和C组在心率、平均动脉压、心输出量、尿量方面均优于A组(P<0.05),而B组和C组比较,差异无统计学意义;A组和B组的肺水肿发生率明显低于C组(P<0.05),而A组和B组比较,差异无统计学意义;单纯右室心肌梗死组的CVP明显高于非单纯右室心肌梗死组的CVP(P<0.05).结论 急性右室心肌梗死扩容治疗时中心静脉压(CVP)应维持的最佳范围为13～19 cm H2O.
目的 探討急性右室心肌梗死擴容治療時中心靜脈壓(CVP)應維持的最佳範圍.方法 將68例急性右室心肌梗死併低血壓休剋患者採用隨機對照的原則分為3組(A組、B組、C組),3組均予相同的基礎治療,如休息、吸氧、鎮靜、止痛、抗凝、抗血小闆及再灌註治療,在此治療的基礎上給予擴容治療,使A組患者CVP維持在6～12 cm H2O,B組患者CVP維持在13～19 cm H2O,C組患者CVP維持在20～26 cm H2O,鑑測患者的心率、平均動脈壓、心輸齣量、尿量及肺水腫髮生率,比較各組療效.另分彆計算齣單純右室心肌梗死與非單純右室心肌梗死患者的CVP值併進行比較.結果 B組和C組在心率、平均動脈壓、心輸齣量、尿量方麵均優于A組(P<0.05),而B組和C組比較,差異無統計學意義;A組和B組的肺水腫髮生率明顯低于C組(P<0.05),而A組和B組比較,差異無統計學意義;單純右室心肌梗死組的CVP明顯高于非單純右室心肌梗死組的CVP(P<0.05).結論 急性右室心肌梗死擴容治療時中心靜脈壓(CVP)應維持的最佳範圍為13～19 cm H2O.
목적 탐토급성우실심기경사확용치료시중심정맥압(CVP)응유지적최가범위.방법 장68례급성우실심기경사병저혈압휴극환자채용수궤대조적원칙분위3조(A조、B조、C조),3조균여상동적기출치료,여휴식、흡양、진정、지통、항응、항혈소판급재관주치료,재차치료적기출상급여확용치료,사A조환자CVP유지재6～12 cm H2O,B조환자CVP유지재13～19 cm H2O,C조환자CVP유지재20～26 cm H2O,감측환자적심솔、평균동맥압、심수출량、뇨량급폐수종발생솔,비교각조료효.령분별계산출단순우실심기경사여비단순우실심기경사환자적CVP치병진행비교.결과 B조화C조재심솔、평균동맥압、심수출량、뇨량방면균우우A조(P<0.05),이B조화C조비교,차이무통계학의의;A조화B조적폐수종발생솔명현저우C조(P<0.05),이A조화B조비교,차이무통계학의의;단순우실심기경사조적CVP명현고우비단순우실심기경사조적CVP(P<0.05).결론 급성우실심기경사확용치료시중심정맥압(CVP)응유지적최가범위위13～19 cm H2O.
Objective To explore the optimum range of central venous pressure(CVP) in treating acute right ventricle myocardial infarction. Methods Sixty-eight patients with hypotension and shock due to acute right ventricle myocardial infarction were randomly divided into three groups: group A, group B and group C. All patients received the same basic treatment of rest, oxygen, sedation, analgesic, anticoagulant, anti-platelet and reperfusion therapy. On the basis, expansion treatment was used so that the CVP of patients maintained at 6-12 cm H2O in group A, 13-19 cm H2O in group B and 20-26 cm H2O in group C. Such indicators as heart rate, mean arterial pressure, cardiac output, urine output and incidence of pulmonary edema were monitored. Efficacy of each group was compared. And the CVP of pure right ventricular myocardial infarction was compared with that of non-pure right ventricular myocardial infarction. Results The heart rate, mean arterial pressure, cardiac output and urine output of group B and group C were better than group A (P<0.05), while there was no significant difference between group B and group C; The incidence of pulmonary edema of group A and group B was lower than group C (P<0.05), while there was no significant difference between group A and group B; The CVP of pure right ventricular myocardial infarction was higher than that of non-pure right ventricular myocardial infarction (P<0.05). Conclusion The optimum range of central venous pressure (CVP) in treating acute right ventricle myocardial infarction should be 13-19 cm H2O.
