高位截瘫患者扩容期间胶体渗透压变化的观察

观察高位截瘫患者胶体扩容与胶体渗透压(COP)之间的关系,以评估血容量情况、指导临床扩容治疗。取2011年1月至10月收入我院ICU的高位截瘫患者病例42例,对出现中枢性容量不足的病例以150 mL/h的速度补充胶体液500 mL,观察扩容前及扩容开始后1 h、扩容结束时及扩容结束后4 h的MAP、HR、CVP值并测量COP。结果:MAP、CVP在扩容开始后1 h升高(P<0.05),扩容结束时达高峰,扩容结束后4 h仍维持平稳;HR扩容后各时间段均较扩容前减慢(P<0.05)。COP在扩容后1 h较扩容前升高(P<0.05),扩容结束时达高峰,扩容结束后4 h仍高于扩容前。说明高位截瘫患者胶体扩容效果明显,COP有相应升高,监测胶体渗透压可以反映血容量情况,更好地指导临床补液。

To Observe the changes of Plasma Colloid Osmotic Pressure(COP) During Volume Expansion Therapy For Patients with High Level Paraplegia

To study the relationship between the varying rules of the colliod fluid expansion and the plasma COP in high level paraplegia patients,to know the fluid status and derecte clinic fluid expansion treatment,measuring MAP HR CVP COP of 42 high level paraplegia patients whose MAP lower then 80—90/30—50 mmHg,Then give Gelofusine 150 mL/h for 500 mL,while after begin giving colloid for 1hour,at the end of fluid expansion and after fluid expansion 4 hour,the MAP HR CVP COP were measured.It is reulted that MAP CVP elevated after giving colloid for 1 hour and get peak at the end of fluid expansion,and retain stabilization after 4 hours;while HR get to normal after fluid expansion.COP get results with one accord to MAP CVP.conclused that colloid can expand the blood volume quickly and keep for at least for 4 hours.COP may be a good marker of the fluid status of the high level paraplegia patients.measuring COP could have significant value.