中心静脉压测定在急性右室心梗中应用临床观察.docVIP

中心静脉压测定在急性右室心梗中应用的临床观察 　　【摘要】 目的：探讨中心静脉压测定在急性右心室心梗中的应用价值。方法：按照随机数字表法，将102例急性右室心梗并低血压休克患者分为A组（n=33）、B组（n=36）、C组（n=33）。三组患者均给予相同的基础治疗和扩容治疗，A组、B组、C组的CVP分别维持在6～12 cm H2O、13～19 cm H2O、20～26 cm H2O，比较三组患者的心率（HR）、平均动脉压（MAP）、尿量（UV）、心输出量（CO）以及肺水肿发生率。结果：A组和B组的肺水肿发生率均明显低于C组（P0.05）；B组和C组患者入院治疗12、24 h的HR均显著慢于A组，MAP、UV、CO值均显著高于A组（P0.05）；单纯右室心梗患者的CVP值明显高于非单纯右室心梗患者（P0.05）。结论：中心静脉压测定在急性右室心梗扩容治疗中具有重大意义，其最佳维持范围应在13～19 cm H2O。 　　【关键词】 中心静脉压； 急性右室心肌梗死； 低血压； 扩容治疗 　　中图分类号 R542.22 文献标识码 A 文章编号 1674-6805（2016）9-0005-02 　　【Abstract】 Objective：To explore the application value of central venous pressure in acute right ventricular myocardial infarction.Method：According to the random number table method，102 patients with acute right ventricular myocardial infarction（AMI） were divided into A group（n=33），B group（n=36），C group（n=33）.Three groups were given the same basic treatment and volume expansion therapy，A group，B group，C group of CVP were maintained at 6-12 cm H2O，13-19 cm H2O， 　　20-26 cm H2O，the heart rate（HR），mean arterial pressure（MAP），urine output（UV），cardiac output（CO） and incidence of pulmonary edema of the three groups were compared.Result：The incidence of pulmonary edema in A group and B group were significantly lower than that in C group（P0.05）；admission to hospital for treatment of 12 h and 24 h，the HR of B group and C group were significantly slower than that in C group，UV，CO，MAP were significantly higher than those in A group（P0.05）；CVP values in patients with simple right ventricular myocardial infarction was significantly higher than that of patients with non simple right ventricular infarction（P0.05）.Conclusion：Central venous pressure measurement has great significance in the treatment of acute right ventricular myocardial infarction，and its optimal maintenance range should be between 13-19 cm H2O. 　　【Key words】 Central venous pressure； Acute right ventricular myocardial infarction； Hypotension； Volume expansion therapy 　　First-author’s address：Hengyang No.1 People’s Ho