摘要
目的探讨对腹腔镜肝脏手术患者实施目标导向液体治疗(GDFT)后获得的临床效果。方法选取2020年3月至2023年8月烟台市烟台山医院收治的62例腹腔镜肝脏手术患者作为研究对象,按照随机数字表法分为参照组(31例)与研究组(31例),参照组采用常规方法治疗,研究组采用GDFT治疗。比较两组的简易精神状态检查量表(MMSE)评分、血流动力学指标水平、尿素氮(BUN)水平、乳酸(Lac)水平。结果术前1 d,两组患者MMSE评分比较,差异无统计学意义(P>0.05);术后1、3 d,研究组患者MMSE评分高于参照组,差异有统计学意义(P<0.05)。研究组患者切肝时(T_(2))及手术完毕时(T_(3))心脏指数(CI)高于参照组;T_(2)时中心静脉压(CVP)水平高于参照组,T_(3)时CVP水平低于参照组,差异有统计学意义(P<0.05);入室时(T_(0))、T_(3)时及术后24 h,两组患者BUN水平比较,差异无统计学意义(P>0.05);T_(0)时,两组患者Lac水平比较,差异无统计学意义(P>0.05);T_(3)及术后24 h,研究组患者Lac水平低于参照组,差异有统计学意义(P<0.05)。结论临床对腹腔镜肝脏手术患者合理给予GDFT治疗,对于患者重要脏器血流灌注稳定性以及患者的血流动力学水平维持表现出的作用明显,可以保护患者的脑组织,对于患者的术后认知功能改善有促进作用。
Objective To investigate the clinical effect of goal-directed fluid therapy(GDFT)in patients undergoing laparoscopic liver surgery.Methods A total of 62 patients with laparoscopic liver surgery admitted to Yantai Yantaishan Hospital from March 2020 to August 2023 were selected as the research objects.According to the random number table method,they were divided into the reference group(31 cases)and the study group(31 cases).The reference group was treated with conventional methods,and the study group was treated with GDFT.The mini-mental state examination(MMSE)score,hemodynamic index levels,blood urea nitrogen(BUN)and lactic acid(Lac)levels were compared between the two groups.Results There was no significant difference in MMSE score between the two groups 1 day before operation(P>0.05).At 1 and 3 days after operation,MMSE scores in the study group were higher than those in the reference group,and the differences were statistically significant(P<0.05).The cardiac index(CI)at the time of liver resection(T_(2))and the end of surgery(T_(3))in the study group were higher than those in the control group;The central venous pressure(CVP)level at T_(2) was higher than that in the reference group,and that at T_(3)was lower than that in the reference group,with statistical significance(P<0.05).There were no significant differences in BUN level between the two groups at the time of entry(T_(0)),T_(3)and 24 h after surgery(P>0.05).At T_(0),there was no significant difference in Lac level between the two groups(P>0.05).At T_(3)and 24 h after operation,Lac levels in study group were lower than those in reference group,and the differences were statistically significant(P<0.05).Conclusion In clinical practice,reasonable GDFT treatment for patients undergoing laparoscopic liver surgery has obvious effects on the stability of blood perfusion of patients'important organs and the maintenance of the hemodynamic level of patients,which can protect the brain tissue of patients and promote the improvement of postoperative cognitive func
作者
刘庆
LIU Qing(Department of Hepatobiliary and Pancreatic Surgery,Yantai City Yantai Mountain Hospital,Shandong Province,Yantai264003,China)
出处
《中国当代医药》
CAS
2024年第26期39-42,共4页
China Modern Medicine
关键词
目标导向液体治疗
腹腔镜肝脏手术
简易精神状态检查量表
血流动力学
尿素氮
乳酸
Goal-directed fluid therapy
Laparoscopic liver surgery
Mini-mental state examination
Hemodynamic index
Blood urea nitrogen
Lactic acid
