难治性产后出血患者围手术期中心静脉压与术后肺损伤的相关性  

The correlation between perioperative central venous pressure and postoperative lung injury in patients with intractable postpartum hemorrhage

作　　者：郭蕊 蔡恒宇[1] 郜红艳[1] 杨静[2] 丛建萍[2] Guo Rui;Cai Hengyu;Gao Hongyan;Yang Jing;Cong Jianping(Department of Anesthesiology,Shenyang Maternal and Child Hospital,Shenyang 11001l,China;Department of Obstetrics,Shenyang Maternal and Child Hospital,Shenyang 110011,China)

机构地区：[1]沈阳市妇婴医院麻醉科,辽宁沈阳110011 [2]沈阳市妇婴医院产科,辽宁沈阳110011

出　　处：《实用妇科内分泌电子杂志》2023年第34期1-4,共4页Electronic Journal of Practical Gynecological Endocrinology

基　　金：沈阳市中青年科技创新人才支持计划项目(编号RC210043)。

摘　　要：目的探讨难治性产后出血患者围手术期中心静脉压与术后肺损伤的相关性。方法选取本院收治的98例难治性产后出血患者为研究对象,根据术后是否发生肺损伤分为肺损伤组(42例)、非肺损伤组(56例)。比较两组的血流动力学指标、围手术期液体量,采用多元线性回归分析难治性产后出血患者平均中心静脉压值的影响因素。结果肺损伤组最高动脉乳酸值、平均中心静脉压值、平均心率值高于非肺损伤组,差异有统计学意义(P<0.05);肺损伤组围手术期出量、围手术期入量、围手术期液体平衡量高于非肺损伤组,围手术期液体平均输注速度大于非肺损伤组,差异有统计学意义(P<0.05);多元线性回归分析结果显示,平均中心静脉压值与患者术后肺损伤有关,围手术期液体平均输注速度、围手术期液体平衡量是难治性产后出血患者平均中心静脉压值的影响因素(P<0.05)。结论难治性产后出血患者围手术期中心静脉压与术后肺损伤相关,可以通过降低输液速度和围手术期液体平衡量来降低中心静脉压,从而减少肺损伤的发生。Objective Exploring the correlation between perioperative central venous pressure and postoperative lung injury in patients with intractable postpartum hemorrhage.Methods 98 patients with refractory postpartum hemorrhage admitted to our hospital were selected as the study subjects.They were divided into a lung injury group(42 cases)and a non lung injury group(56 cases)based on whether postoperative lung injury occurred.Compare the hemodynamic indicators and perioperative fluid volume between two groups,and use multiple linear regression to analyze the influencing factors of mean central venous pressure in patients with intractable postpartum hemorrhage.Results The highest arterial lactate value,average central venous pressure value,and average heart rate value in the lung injury group were higher than those in the non lung injury group,and the differences were statistically significant(P<0.05);The perioperative output,inflow,and fluid balance of the lung injury group were higher than those of the non lung injury group,and the average fluid infusion rate during the perioperative period was higher than that of the non lung injury group,with statistical significance(P<o.05);The results of multiple linear regression analysis showed that the average central venous pressure was related to postoperative lung injury in patients.The average perioperative fluid infusion rate and perioperative fluid balance were the influencing factors of the average central venous pressure in patients with refractory postpartum hemorrhage(P<o.05).Conclusion Perioperative central venous pressure is associated with postoperative lung injury in patients with intractable postpartum hemorrhage,and can be reduced by reducing infusion speed and perioperative fluid balance,thereby reducing the occurrence of lung injury.

关 键 词：难治性产后出血 肺损伤 中心静脉压 

分 类 号：R714.461[医药卫生—妇产科学]