应用中心静脉压监测评估连续性血液净化患者的容量

目的探讨在连续性血液净化治疗中指导超滤量调节的最佳评价指标.方法监测15例危重患者在连续性血液净化治疗中的中心静脉压、平均动脉压.通过比较在不同指标下调整超滤量后液体管理的效果,评价中心静脉压对反映患者容量状况的敏感性.结果比较发现,15例患者中心静脉压与超滤量之间的相关系数为-0.2624,比平均动脉压与超滤量的相关系数(-0.05)高,两者差异有显著性意义(P<0.05).结论连续性血液净化治疗中,监测中心静脉压来评估患者容量状况较平均动脉压更为敏感,为实现个体化的液体管理提供了更为可靠的指标.

Evaluating volume status by monitoring central venous pressure of patients treated with continuous blood purification

Objective To find out a better evaluation indicator to adjust ultrafiltration volume during blood purification. Methods From March to October in 2004, central venous pressure and mean arterial blood pressure of 15 serious patients were measured as indicators to adjust ultrafiltration volume during hemodialysis. The effectiveness of adjusting ultrafiltration volume according to different indicators on the management of blood volume had been compared, and the sensibility of monitoring cen tral venous pressure to reflect patients' volume status was assessed. Results The correlation coefficient(-0. 2624) between cen tral venous pressure and ultrafiltration volume was significantly higher than that between mean arterial blood pressure and ul trafiltration volume(-0. 05). Conclusion During continuous blood purification, central venous pressure was found to be more sensitive than mean arterial blood pressure for the evaluation of the volume status. And monitoring central venous pressure could provide a more exact and reliable indicator for individual liquor management.