监测中心静脉压在神经外科危重患者治疗中的应用效果
吕新文,张鹏 * ,宋建荣,周小龙,朱峰,蔡珂
宝鸡市中心医院,陕西 宝鸡,721008
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摘要:
目的 探讨监测中心静脉压在神经外科危重患者最大限度脱水降颅压中的意义。方法 回顾性分析 2014年 11月至 2016年 11月在我院神经外科治疗的 64例危重患者的临床资料,观察并分析其治疗方法及效果。结果 64例患者行中心静脉压监测后,急性期死亡 8例(12.5%)。其余 56例随访 6耀15个月,平均 7.5个月,按 GOS评分:恢复良好 13例(23.2%),中度残疾17例(30.4%),严重残疾 20例(35.7%),植物状态 4例(7.1%),死亡 2例(3.6%)。结论 在神经外科危重患者早期非手术治疗中,行中心静脉压监测,可有效解决最大限度脱水降颅压与保证有效血容量之间的矛盾,提高疗效并减少并发症。
关键词:中心静脉压;脱水;降颅压
中图分类号: R651.1文献标志码:A文章编号: 2096-1413(2018)07-0091-02
Application effect of monitoring central venous pressure in the treatment of
critically ill patients in neurosurgery department
LV Xin-wen,ZHANG Peng * ,SONG Jian-rong,ZHOU Xiao-long, ZHU Feng,CAIKe
(Baoji Central Hospital, Baoji 721008, China)
ABSTRACT: Objective To explore the significance of monitoring centralvenous pressure on maximum dehydration and intracranial pressure reduction in critically illpatientsin neurosurgery department. Methods The clinicaldata of 64 criticallyill patients who were treated in neuro surgery department in our hospital from November 2014 to November 2016 were retrospectively analyzed,and the treatment methods and effects were observed. Results Among the 64 patients who underwent centralvenous pressure monitoring, 8 cases (12.5% ) died in acute phase.The remaining56 patients were followed up for 6-15 months,with an average of 7.5 months,the results of GOS score showed good recovery in 13 cases(23.2% ),moderate disability in 17 cases (30.4% ),severe disability in 20 cases (35.7%), 4 cases of vegetative state (7.1% ),2 cases (3.6% )of death.Conclusion In theearly non-surgical treatment of critically illpatients in neurosurgery department,centralvenous pressure monitoring can effectively solve the contradiction between maximum dehydration and intracranial pressure reduction and effective blood volume,which can improve curative effectand reduce complications KEYWORDS: centralvenous pressure; dehydration; intracranial pressure reduction
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