中心静脉压监测下急性右心室梗死扩容治疗  

Volume Expansion under Central Venous Pressure Monitoring for Acute Right Ventricular Infarction

作　　者：彭景添[1] 张智亮[1] 王梦洪[1] 吴友平[1] 黄俊[1] 路军[1] PENG Jing-tian;ZHANG Zhi-liang;WANG Meng-hong;WU You-ping;HUANG Jun;LU Jun(Department of Cardiology,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院心内科,南昌330006

出　　处：《南昌大学学报（医学版）》2018年第1期69-71,共3页Journal of Nanchang University：Medical Sciences

摘　　要：目的评估中心静脉压监测在急性右心室梗死扩容治疗中的价值。方法 2002年6月至2016年6月共收治100例急性右心室梗死患者,并对其临床资料进行回顾性分析。结果 100例急性右心室梗死,70例合并右心功能不全及低血压休克,扩容等治疗后95%稳定。治疗前中心静脉压(18.6±2.2)cmH_2O[(1.823±0.216)kPa]。血管开通前后中心静脉压下降(6.5±2.0)cmH_2O[(0.637±0.196)kPa],血压不稳者快速扩容补液。住院前3d中心静脉压为(22.8±2.4)cmH_2O[(2.234±0.235)kPa]时,可获得稳定血压;日输液量和输液速度因人而异,依据中心静脉压和血压进行随时调节。结论急性右心室梗死治疗成功的关键:早期的识别和诊断,严密监测生命体征、心功能及血液动力学改变,适时、适度、适量地扩容治疗,尽早开通梗死相关血管。Objective To evaluate the value of central venous pressure(CVP)monitoring in the treatment of acute right ventricular infarction(ARVI)with volume expansion.Methods A retrospective analysis was performed in 100 patients treated from June 2002 to June 2016 for ARVI.Results Among the 100 patients,70 had right ventricular dysfunction and hypotensive shock,and 95%of them had stable blood pressure after volume expansion treatment.The CVP was(18.6±2.2)cmH 2O/(1.823±0.216)kPa before treatment,and(6.5±2.0)cmH 2O/(0.637±0.196)kPa during reperfusion.Patients with unstable blood pressure were given rapid volume expansion.The stable blood pressure could be obtained when the CVP was(22.8±2.4)cmH 2O/(2.234±0.235)kPa within 3 days before hospital admission.The volume and velocity of infusion of were adjusted according to CVP and blood pressure.Conclusion The keys for successful treatment of ARVI are early diagnosis,close monitoring of vital signs,cardiac function and hemodynamic changes,appropriate volume expansion,and timely reperfusion.

关 键 词：右心室梗死 急性 中心静脉压 扩容治疗 

分 类 号：R542.22[医药卫生—心血管疾病]