术中目标导向液体治疗对胃肠道手术麻醉患者的影响。

The effect of intraoperative goal-directed fluid therapy in patients under anesthesia for gastrointestinal surgery.

作者信息

Zhang Jun, Li Xiao-Wen, Xie Bing-Feng

机构信息

Department of Anesthesiology, The Second Hospital of Longyan, Longyan 364000, Fujian Province, China.

Department of Gastrointestinal Surgery, Longyan First Hospital, Longyan 364000, Fujian Province, China.

出版信息

World J Gastrointest Surg. 2024 Sep 27;16(9):2815-2822. doi: 10.4240/wjgs.v16.i9.2815.

DOI:10.4240/wjgs.v16.i9.2815

PMID:39351556

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11438805/

Abstract

BACKGROUND

Intraoperative fluid management is an important aspect of anesthesia management in gastrointestinal surgery. Intraoperative goal-directed fluid therapy (GDFT) is a method for optimizing a patient's physiological state by monitoring and regulating fluid input in real-time.

AIM

To evaluate the efficacy of intraoperative GDFT in patients under anesthesia for gastrointestinal surgery.

METHODS

This study utilized a retrospective comparative study design and included 60 patients who underwent gastrointestinal surgery at a hospital. The experimental group (GDFT group) and the control group, each comprising 30 patients, received intraoperative GDFT and traditional fluid management strategies, respectively. The effect of GDFT was evaluated by comparing postoperative recovery, complication rates, hospitalization time, and other indicators between the two patient groups.

RESULTS

Intraoperative blood loss in the experimental and control groups was 296.64 ± 46.71 mL and 470.05 ± 73.26 mL ( < 0.001), and urine volume was 415.13 ± 96.72 mL and 239.15 ± 94.69 mL ( < 0.001), respectively. The postoperative recovery time was 5.44 ± 1.1 days for the experimental group compared to 7.59 ± 1.45 days ( < 0.001) for the control group. Hospitalization time for the experimental group was 10.87 ± 2.36 days 13.65 ± 3 days for the control group ( < 0.001). The visual analogue scale scores of the experimental and control groups at 24 h and 48 h post-surgery were 3.38 ± 0.79 and 4.51 ± 0.86, and 2.05 ± 0.57 and 3.51 ± 0.97 ( < 0.001), respectively. The cardiac output of the experimental and control groups was 5.99 ± 1.04 L/min and 4.88 ± 1.17 L/min, respectively, while the pulse pressure variability for these two groups was 10.87 ± 2.36% and 17.5 ± 3.21%, respectively.

CONCLUSION

The application of GDFT in gastrointestinal surgery can significantly improve postoperative recovery, reduce the incidence of complications, and shorten hospital stays.

摘要

背景

术中液体管理是胃肠外科麻醉管理的重要方面。术中目标导向性液体治疗（GDFT）是一种通过实时监测和调节液体输入来优化患者生理状态的方法。

目的

评估术中GDFT在胃肠外科麻醉患者中的疗效。

方法

本研究采用回顾性对比研究设计，纳入了一家医院60例行胃肠外科手术的患者。实验组（GDFT组）和对照组各30例患者，分别接受术中GDFT和传统液体管理策略。通过比较两组患者术后恢复情况、并发症发生率、住院时间等指标来评估GDFT的效果。

结果

实验组和对照组术中失血量分别为296.64±46.71 mL和470.05±73.26 mL（<0.001），尿量分别为415.13±96.72 mL和239.15±94.69 mL（<0.001）。实验组术后恢复时间为5.44±1.1天，对照组为7.59±1.45天（<0.001）。实验组住院时间为10.87±2.36天，对照组为13.65±3天（<0.001）。实验组和对照组术后24小时及48小时的视觉模拟评分分别为3.38±0.79和4.51±0.86，以及2.05±0.57和3.51±0.97（<0.001）。实验组和对照组的心输出量分别为5.99±1.04 L/分钟和4.88±1.17 L/分钟，而两组的脉压变异率分别为10.87±2.36%和17.5±3.21%。