中心静脉压变异度在危重症患者诊断性失血中的价值  

Value of central venous pressure variability in diagnostic blood loss in critically ill patients

作　　者：成昌盛[1] 汪媛媛[1] CHENG Changsheng;WANG Yuanyuan(Outpatient and Emergency Center,Jiangsu Provincial Hospital of Traditional Chinese Medicine,Nanjing,Jiangsu,210029)

机构地区：[1]江苏省中医院门急诊中心,江苏南京210029

出　　处：《实用临床医药杂志》2020年第3期44-47,共4页Journal of Clinical Medicine in Practice

基　　金：江苏省中医院院级课题(Y18063).

摘　　要：目的探讨中心静脉压(CVP)变异度在危重症患者诊断性失血中的价值。方法选择本院急诊科ICU收住的97例危重病患者。根据急性生理与慢性健康(APACHEⅡ)评分进行病情严重程度分级,将患者分为A组、B组、C组。记录患者临床指标,并比较采血前后的差异。检测采血后CVP变异度,分析其与采血量的相关性。结果患者入院后第1次空腹采血前后血红蛋白、平均动脉压、心率无显著差异(P>0.05),CVP有显著差异(P<0.01)。CVP变异度仅与采血量呈正相关(r=0.903,P<0.05),与血红蛋白差值、平均动脉压差值、心率差值无显著相关性(r=0.621,P=0.320;r=0.701,P=0.231;r=0.675,P=0.256)。B组CVP变异度、采血量较A组高(P<0.01),C组CVP变异度、采血量均高于A、B组,差异有统计学意义(P<0.01)。结论CVP变异度能有效评估危重症患者诊断性失血的严重程度,CVP变异度监测能及时采取措施避免病情恶化。Objective To evaluate the value of central venous pressure(CVP)variability in diagnostic blood loss in critically ill patients.Methods A total of 97 critically ill patients were selected.These patients were divided into groups A,B and C according to severity grading of Acute Physiology and Chronic Health Evaluation(APACHEⅡ)scores.Clinical indicators were recorded,and were compared before and after blood collection.The CVP variability was detected after blood collection and its correlation with blood collection was analyzed.Results There were no significant differences in hemoglobin,mean arterial pressure and heart rate in fasting blood samples before and after first fasting blood collection(P>0.05),while CVP showed a significant difference(P<0.01).CVP variability was only positively correlated with blood sampling(r=0.903,P<0.05),but showed no significant correlation with hemoglobin,mean arterial pressure,heart rate(r=0.621,P=0.320;r=0.701,P=0.231;r=0.675,P=0.256).The CVP variability and blood collection volume in group B was significantly higher than that of group A(P<0.01),and were higher in group C was higher than that of group A and B,the differences were statistically significant(P<0.01).Conclusion CVP variability can effectively assess the severity of diagnostic blood loss in critically ill patients.By monitoring CVP variability,measures can be taken to avoid deterioration of the disease.

关 键 词：中心静脉压变异度 危重症 诊断性失血 评估 

分 类 号：R331[医药卫生—人体生理学]