摘要
目的探讨目标导向液体治疗在老年膀胱癌根治术的临床研究。方法选取老年膀胱癌根治术患者76例,随机分为两组,38例患者实施常规治疗为Ⅰ组,38例患者在常规治疗基础上采用目标导向液体治疗为Ⅱ组,比较两组患者的治疗效果。结果Ⅱ组患者在麻醉诱导插管后(T_1)、手术开始时(T_2)、手术1 h时(T_3)、手术结束时(T_4)心输出指数(CI)、每搏变异度(SVV)、平均动脉压(MAP)、中心静脉压(CVP)、中心静脉血氧饱和度(ScvO_2)、氧供指数(DO_2I)、氧耗指数(VO_2l)、氧摄取率(ERO_2)均明显高于Ⅰ组,在T_1、T_2、T_3、T_4时动脉血清乳酸(Lac)、S100β均明显低于Ⅰ组,尿量、胶体液量均明显多于Ⅰ组,而晶体液量、总输入量、住院时间、住院费用均明显少于Ⅰ组,恶心呕吐、低血压等并发症发生率均明显低于Ⅰ组,术后排气时间、术后进食时间均明显早于Ⅰ组,差异均有统计学意义(P<0.05)。结论目标导向液体治疗更有助于稳定老年膀胱癌根治术患者的血流动力学状况,能有效维持机体氧供需平衡,保证微循环灌注,还可明显缩短患者的治疗时间,减少患者的治疗费用,并发症少且安全性高,值得临床推广使用。
Objective To investigate clinical studies in elderly bladder carcinomaradical resection treatment goal directed fluid. Methods Seventy-six elderly patients with radical resection of bladder cancer were selected who were randomly divided into two groups. 38 patients received routine treatment as group I. Based on routine treat- ment, 38 patients received goal-directed fluid therapy as group II. Treatment effect was compared between the two groups. Results Cardiac index （ CI）, stroke volume variation （ SVV）, mean arterial pressure （ MAP）, central ve- nous pressure （ CVP）, central venous oxygen saturation （ ScvO2 ）, oxygen supply index （ DO21 ）, oxygen consump- tion index（ VOEI） , oxygen uptake rate（ ERO2 ） were significantly higher in group II than those in group I at T1, T2, T3, T4, while lactate（Lac）, S100β were significantly lower in group II than those in group I at T1, T2, T3, T4. The urine volume and colloidal infusion were significantly more in group II than those in group I at T1 , T2, T3 , T4, while the erystalloid infusion volume, total liquid infusion volume, hospitalization time and expenses were significantly less in group II than those in group I , while the complication incidences of nausea, vomiting or hy- potension were significantly lower in group II than those in group I. The postoperative first passage of flatus and postoperative food-taking time were significantly earlier in group II than those in group I （P 〈 0. 05 ）. Conclusion Goal-directed fluid therapy is beneficial for stabilization of hemodynamic status, maintenance of oxygen balance of supply and demand, as well as rapid postoperative recovery in elderly patients with radical resection of bladder cancer.
出处
《安徽医科大学学报》
CAS
北大核心
2016年第4期569-573,共5页
Acta Universitatis Medicinalis Anhui
基金
河北省高等学校科学技术研究指导项目(编号:Z2015006)
2015年河北省政府资助临床医学优秀人才项目
关键词
老年
膀胱癌根治术
目标导向液体
临床效果
older
radical resection of bladder cancer
goal-directed fluid
clinical effect
