摘要
背景目标导向液体治疗（goal-directed fluid therapy，GDFT）是以功能性血流动力学指标为导向，实施个体化补液方案，但其在神经外科领域，尤其是在颅内肿瘤切除术中应用较少，对患者术后转归的影响仍不明确。目的综述GDFT在颅内肿瘤切除术中的应用。内容从临床研究的角度出发，针对围手术期使用液体的种类、液体管理方案的选择，阐述GDFT对颅内肿瘤切除术患者术后转归的影响。趋向GDFT在颅内肿瘤切除术中应用的优势及对患者术后转归的影响还需进一步研究。
Background The goal-directed fluid therapy （GDFT） is a personalized treatment paradigm with reference of functional hemodynamics. However, it has been rarely used in neurosurgery, especially in intraeranial tumor resection, and it remains unclear whether it affects prognosis of the patients. Objective To review current progress of GDFT in patients undergoing intracranial tumor resection. Content To maintain the homeostasis of body fluid in perioperative period, either colloid and crystalloid solutions were used. Colloid solutions effectively increase vascular volume and oxygen supply, but may cause accumulation of platelets, initiation of coagulation, and injury in the kidney. Larger volumes of crystalloid solution may be needed to obtain equivalent hemodynamic alterations as colloid solution. During intracranial tumorectomy, fluid therapy with either colloid or crystalloid solution has been successfully applied under personalized paradigms, which are based on patients＇ stroke volume variation （SVV） and pulse pressure variation （PPV）. The strategy provides stable hemodynamic parameters, promotes postoperative recovery, and reduces morbidity of complications and brain injury. Trend The GDFT with references of SVV and PPV is suitable to maintain normal hemodynamics in intracranial tumorectomy. Further investigations with larger sample sizes are warranted to verify the results.
作者
冯帅
肖玮
王天龙
Feng Shuai, Xiao Wei, Wang Tianlong(Department of A nesthesiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, Chin)
出处
《国际麻醉学与复苏杂志》
CAS
2018年第3期264-267,281,共5页
International Journal of Anesthesiology and Resuscitation
基金
北京市医院管理局“登峰计划”专项经费资助（DFL20150802）
2015年度北京市青年骨干个人项目（2014000020124G160）
关键词
目标导向液体治疗
颅内肿瘤手术
Goal-directed fluid therapy
Operation of intracranial tumor
