每搏输出量变异度用于重型颅脑损伤患者容量治疗反应的评价观察  

Evaluation of stroke volume variation for patients with severe traumatic brain injury treatment response capacity

作　　者：张文青[1] 郑鹏[1] 徐坡[2] 

机构地区：[1]靖江市人民医院,江苏靖江214500 [2]靖江市中医院,江苏靖江214500

出　　处：《基层医学论坛》2014年第35期4753-4755,共3页The Medical Forum

摘　　要：目的监测每搏输出量变异度（SVV）对重型颅脑损伤患者容量治疗的反应，观察其对预后的影响。方法选择2013年8月—2014年3月入住我院重症医学科，当日急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分≥15分，ICU住院时间≥3 d，3分≤GCS≤8分，需机械通气的50例重型颅脑损伤患者，随机分为扩容后采用Flotrac/Vigileo系统监测SVV达10%目标导向治疗组（即试验组），另一组监测扩容后中心静脉压（CVP）达8～12 mm Hg（即对照组）。检测血清神经元特异性烯醇化酶（NSE）水平，随访记录患者受伤后3个月～6个月格拉斯哥预后评分（GOS），比较2组患者NSE水平及预后的差异。结果试验组与对照组相比较，血清中的NSE水平低，预后较好，差别有统计学意义。结论扩容后采用Flotrac/Vigileo系统监测SVV达10%目标导向治疗，可以明显降低重型颅脑损伤患者的血清NSE水平，改善预后。ObjectiveMonitor stroke volume variation （SVV） capacity of treatment response in patients with severe head injury, observe its effect on prognosis.MethodsIn 2013 August to 2014 March, choiceing 50 patients with severe craniocerebral injury who need to mechanical ventilation from ICU of people＆#39;s Hospital of Jingjiang city, Jiangsu Province, the standard to acute physiology and Chronic health evaluation system？II？（APACHE Ⅱ）≥15, ICU≥3 days of hospitalization, and 3≤GCS≤8.These people were randomly divided into two groups; Group A is to use the Flotrac＆amp;Vigileo system to monitor SVV when it go up to 10% goal-directed treatment group after complement of blood volume（experimental group）;Group B is to monitor CVP when it go up to 8～12 mm Hg after complement of blood volume （control group）.To monitor the serum levels of NSE, Follow-up and record 3～ 6 months of these patients with GOS prognostic score, compared the two groups with serum NSE level and prognosis.ResultsCompared with experimental group and control group, the differences between the serum level of NSE and prognostic have statistically significant.ConclusionTo use the Flotrac/Vigileo system to monitor SVV when it go up to 10% goal-directed treatment group after complement of blood volume can significantly reduce serum NSE levels in patients with severe head injury, improve the prognosis.

关 键 词：重型颅脑损伤 SVV CVP NSE预后 

分 类 号：R445.2[医药卫生—影像医学与核医学] R651.15[医药卫生—诊断学]