摘要
目的探讨利用FloTrac-Vigileo系统监测血流动力学进行目标导向液体治疗对结核性毁损肺患者全肺切除术中及术后并发症的影响。方法选择2020年1月至2021年12月成都市公共卫生临床医疗中心收治内科治疗无效并已接受全肺切除术的结核性毁损肺患者随机分层抽样,在使用FloTrac-Vigileo系统指导液体治疗的手术患者中简单随机抽取19例为S组,在未使用FloTrac-Vigileo系统的常规液体治疗患者简单随机抽取20例为C组。共收集39例患者。分别记录两组患者进入手术室时(T0)、气管插管后(T1)、手术开始时(T2)、阻断肺动脉后(T3)、手术结束时(T4)各血流动力学参数变化。分析两组患者术中液体使用量、手术时间、手术出血量及使用血管活性药物和术毕使用利尿剂的情况。观察术后并发症。结果①两组患者一般情况、手术时间、手术出血量比较无统计学差异(P>0.05);两组患者术中平均动脉压(MAP)及心率(HR)组间比较无统计学差异(P>0.05)。②两组液体使用情况,S组比C组输液总量明显减少,其中胶体量增多,晶体量减少,具有统计学差异(P<0.05),而输血量比较无统计学差异(P>0.05)。③术中使用血管活性药物的次数S组低于C组,术毕使用利尿剂的用量S组低于C组,具有统计学差异(P<0.05)。④术后并发症观察,S组术后并发症减少,特别是肺水肿,低血压发生率大大降低,具有统计学差异(P<0.05)。结论利用FloTrac-Vigileo监测血流动力学进行目标导向液体治疗在结核性毁损肺患者全肺切除术中,可以指导术中更合理有效的液体治疗及精准用药,对减少术后严重并发症的发生率,加快术后康复具有重要参考意义。
Objective Discuss with FloTrac-Vigileo system monitoring hemodynamic goal-directed fluid therapy in patients with tuberculous damaged lung pneumonectomy and the effect of postoperative complications.Method From January 2020 to December 2021,patients with tuberculous destroyed lung(TDL)who did not respond to medical treatment and had received total pneumonectomy in our hospital were randomly stratified.Group S was randomly selected from 19 surgical patients who were treated with FloTrac-Vigileo and group C was randomly selected from 20 patients who were not treated with FloTrac-Vigileo.A total of 39 patients were selected.Hemodynamic parameters of 2 groups were recorded when patients entered the operating room(T0),after endotracheal intubation(T1),at the beginning of surgery(T2),after pulmonary artery occlusion(T3)and at the end of surgery(T4).The amount of fluid used during operation,operation time,operation blood loss,use of vasoactive drugs and use of diuretics after operation were analyzed.Postoperative complications were observed.Result There were no statistically significant differences in the general situation,operation time and amount of surgical bleeding between the two groups(P>0.05);There were no significant differences in intraoperative mean arterial pressure(MAP)and heart rate(HR)between 2 groups(P>0.05).In terms of liquid use between the two groups,the total amount of infusion in group S was significantly lower than that in group C,with an increase in colloidal amount and a decrease in crystal amount(P<0.05),while there was no significant difference in the amount of transfusion(P>0.05).3.The number of intraoperative vasoactive drugs used in group S was lower than that in group C,and the number of post-operative diuretics used in group S was lower than that in group C,with statistical differences(P<0.05).4.Postoperative complications were observed,postoperative complications were reduced in group S,especially pulmonary edema,and the incidence of hypotension was significantly reduced,with statistical d
作者
喻娟
徐芬兰
Yu Juan;Xu Fenlan(Department of Anesthesiology,Public Health Clinical Center of Chengdu,Chengdu 610000,China)
出处
《新发传染病电子杂志》
2023年第2期18-22,共5页
Electronic Journal of Emerging Infectious Diseases
基金
四川省成都市卫生健康委员会科研课题(2021436)。
