Zhang Yunfeng, Zhan Linsen, Li Dong, Huang Gang, Lan Yunping
Department of Anaesthesiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, Zhejiang Province, China.
Wideochir Inne Tech Maloinwazyjne. 2023 Sep;18(3):460-466. doi: 10.5114/wiitm.2023.128010. Epub 2023 Sep 1.
Colorectal cancer is a clinically common malignancy arising in the digestive tract.
To evaluate the influence of goal-directed fluid therapy (GDFT) guided by the Vigileo-FloTrac system on intestinal mucosal barrier function in elderly patients with colorectal cancer.
A prospective study was conducted on 106 elderly patients with colorectal cancer. They were divided into control and research groups (n = 53) using a random number table, and subjected to conventional fluid therapy and Vigileo-FloTrac system-guided GDFT, respectively. Their intraoperative indicators, postoperative indicators, and changes of haemodynamics, oxygen metabolism, intestinal mucosal barrier function at different time points, and incidence rates of complications were compared.
Compared with the control group, the intraoperative urine volume, colloid fluid volume, crystalloid fluid volume, and total infusion volume were lower, and the first postoperative exhaust time, first postoperative feeding time, and hospital stay were shorter in the research group (p < 0.05). At T and T, mean artery pressure, heart rate, central venous pressure, oxygen consumption, oxygen delivery, and oxygen extraction ratio in the research group were lower than in the control group, but all of them first rose and then fell in the 2 groups (p < 0.05). On the 3 day after surgery, the levels of serum endothelin, diamine oxidase and D-lactate declined in both groups, and the decline was more obvious in the research group (p < 0.05).
GDFT guided by the Vigileo-FloTrac system is beneficial to the prognosis of patients by effectively decreasing fluid infusion.
结直肠癌是消化道临床常见的恶性肿瘤。
评估Vigileo - FloTrac系统引导的目标导向液体治疗（GDFT）对老年结直肠癌患者肠道黏膜屏障功能的影响。
对106例老年结直肠癌患者进行前瞻性研究。采用随机数字表法将其分为对照组和研究组（n = 53），分别接受传统液体治疗和Vigileo - FloTrac系统引导的GDFT。比较两组患者的术中指标、术后指标、不同时间点的血流动力学、氧代谢、肠道黏膜屏障功能变化及并发症发生率。
与对照组相比，研究组术中尿量、胶体液量、晶体液量及总输液量均较低，术后首次排气时间、首次进食时间及住院时间均较短（p < 0.05）。在T1和T2时，研究组平均动脉压、心率、中心静脉压、氧耗量、氧输送量及氧摄取率均低于对照组，但两组均先升高后下降（p < 0.05）。术后第3天，两组血清内皮素、二胺氧化酶及D - 乳酸水平均下降，研究组下降更明显（p < 0.05）。
Vigileo - FloTrac系统引导的GDFT通过有效减少液体输注量，有利于患者预后。
