中心静脉压cvp监测

As the only big agricultural village in Tianding Township, some achievements have been made through the beneficial exploration of villagers' autonomy in family planning for more than a year.
开放式CVP测量法
测压：
①转动三通，使输液管与中心静脉端想通，开放NS冲管，确定管路通 畅。
② 转动三通，使输液管与测压管相通，液面在测压管内上升，液面 要高于病人实际的CVP值，同时液体不能从上端管口流出。
适应证
ICU CCU 急诊科
休克、心肺复苏后、体外循环心脏手术后、 严重的高血压、严重创伤、
外科大手术及大手术后患者及其它危重患者
危重病人血流动力学监测
漂浮导管 监测cvp
中心静脉导管 监测CVP
As the only big agricultural village in Tianding Township, some achievements have been made through the beneficial exploration of villagers' autonomy in family planning for more than a year.
影响中心静脉压的因素
心包积血/液：右心室的顺应性，三尖瓣 静脉系统张力：血管张力 胸腔的压力：气胸、胸腔积液/血、纵隔气肿；正压机
械通气，高PEEP； 腹内高压等能使中心静脉压偏高 低血容量、脱水、周围血管张力下降等使中心静脉压偏
低
As the only big agricultural village in Tianding Township, some achievements have been made through the beneficial exploration of villagers' autonomy in family planning for more than a year.
探讨的内容：
1、CVP的定义及置管途径。 2、CVP的适应征、禁忌征。 3、CVP监测的临床意义。 4、影响CVP的因素。 5、 CVP监测临床应用的注意事项。 6、 CVP的测量。 7、 CVP的临床护理要点。
As the only big agricultural village in Tianding Township, some achievements have been made through the beneficial exploration of villagers' autonomy in family planning for more than a year.
开放式 CVP测量法
严格执行无菌操作。 各管道连接紧密。 零点调节：将测压管刻度上的“0”调到
与右心房相平行水平处，或者用水平仪标定右 心房水平在测压管上的读数，该读数就是零点。
零点位置：右侧第四肋腋中线的水平
确定管道通畅：①回血好。
②液面随呼吸上、下波动。
As the only big agricultural village in Tianding Township, some achievements have been made through the beneficial exploration of villagers' autonomy in family planning for more than a year.
CVP监测的临床意义:
过高： CVP>15-20cmH2O(1.5-2kPa)
补液量过多或过快 右心衰竭 血管收缩 心包填塞 急性或慢性肺动脉高血压 机械通气和高呼气末正压
As the only big agricultural village in Tianding Township, some achievements have been made through the beneficial exploration of villagers' autonomy in family planning for more than a year.
As the only big agricultural village in Tianding Township, some achievements have been made through the beneficial exploration of villagers' autonomy in family planning for more than a year.
CVP监测的临床意义：
中心静脉压并不能直接反映 病人的血容量，它所反映的是心 脏对回心血量的泵出能力，并提 示静脉回心血量是否充足。
As the only big agricultural village in Tianding Township, some achievements have been made through the beneficial exploration of villagers' autonomy in family planning for more than a year.
补液冲击试验
中心静脉压正常，血压低下，提示心功能不全 或血容量不足，可予补液试验：
取等渗盐水250ml于5-10分钟内给予静脉注入。 若血压升高而中心静脉压不变，提示血容量不
足。 若血压不变而中心静脉压升高3-5cmH2O，提示
心功能不全。
As the only big agricultural village in Tianding Township, some achievements have been made through the beneficial exploration of villagers' autonomy in family planning for more than a year.
中心静脉压（CVP）监测及 临床意义
严永香
As the only big agricultural village in Tianding Township, some achievements have been made through the beneficial exploration of villagers' autonomy in family planning for more than a year.
As the only big agricultural village in Tianding Township, some achievements have been made through the beneficial exploration of villagers' autonomy in family planning for more than a year.
CVP监测的临床意义:
过低CVP<2.4cmH2O(0.24kPa) 1. 血容量不足：失血，缺水 2. 血管扩张 3. 血管收缩扩张功能失常：败血症
As the only big agricultural village in Tianding Township, some achievements have been made through the beneficial exploration of villagers' autonomy in family planning for more than a year.
中心静脉压（CVP):
中心静脉压（central venous pressure） 是指血液流经右心房及上、下腔静脉胸腔段压 力。 正常值为5cmH2O-12cmH2O 是右心室功能和血容量的 常用监测指标
As the only big agricultural village in Tianding Township, some achievements have been made through the beneficial exploration of villagers' autonomy in family planning for more than a year.
中心静脉穿刺部位：
1、颈内静脉：
2、锁骨下静脉： 3、ห้องสมุดไป่ตู้静脉：
临床一般少用
As the only big agricultural village in Tianding Township, some achievements have been made through the beneficial exploration of villagers' autonomy in family planning for more than a year.
CVP 的测量
开放式测量法 封闭式测量法
As the only big agricultural village in Tianding Township, some achievements have been made through the beneficial exploration of villagers' autonomy in family planning for more than a year.
禁忌证
局部破损、感染。 有出血倾向者。
As the only big agricultural village in Tianding Township, some achievements have been made through the beneficial exploration of villagers' autonomy in family planning for more than a year.