中心静脉压监测在重型颅脑损伤液体疗法中的临床应用

目的：探讨适合重型颅脑损伤病人治疗的中心静脉压（CVP）监测范围，指导临床补液。方法：通过对60例病人低灌注和高灌注补液方法下CVP、颅内压（ICP）、脑组织氧分压（PbrO2）的监测，统计分析既能保持有效脑灌注和脑代谢又兼顾内环境相对稳定的CVP适合范围，并依此调整液体及输液速度。结果：CVP数值维持在3-7cmH2O范围内病人的ICP及PbrO2指标相对正常，病人的抢救成活率明显增高，病死率及致残率明显降低。结论：通过对CVP、ICP、PbrO2的联合监测所得出的CVP数值既能保证体循环的稳定又能结合重型颅脑损伤的特点，用以作为衡量临床输液量及输液速度的标准能有效防止因输液量及速度不当所造成脑继发性损害。

THE CLINICAL APPLICATION OF CENTRAL VENOUS PRESSURE IN THE FLUID THERAPY OF SEVERE BRAIN INJURY

OBJECTIVE: Find the area of central venous pressure (CVP) of severe head injury so that therapy may be described. Methods:We inspect CVP, PbrO2 and ICP for a part of patients by the fluid therapy of low cerebral perfusion and high cerebral perfusion we can draw the adapt area of CVP by statistis analysis that both can maintain the relatively stabilization of intracellular fluid and can keep the cerebral perfusion and the cerebral metabolism. According to the adapt area of CVP, we can adjust the fluid volume and the speed of venous transtu-sion. Results: If the CVP level is between 4 and 7 cmH2O, the patent' s index of ICP and PbrO2, can relatively normal. The livability is evidently improvement. The mortality and disability is evidently fall. Conclusion: We can draw the date of CVP by inspecting CVP, ICP and PbrO2 that both can maintain the stabilization of the systemic according to the standard date, we can adjust the speed of intravenous infusions to prevent the brain injury of secondary brain damage.