摘要
目的探析目标导向液体治疗(GDT)对胶质瘤开颅术患者预后的影响,神经外科病人的液体管理理论参考。方法 2011年10月至2014年7月在我院接受胶质瘤开颅术治疗的44例患者的临床资料。随机将患者分为观察组(目标导向液体治疗组,G组)和对照组(常规治疗组,C组)两组,每组22例。比较两者患者的基线资料、血渗透压、液体治疗方案、住院时间、术后并发症的发生率、血液动力学相关指标、氧供应相关指标以及不同时刻血S100-β与血乳酸的浓度。结果两组患者的年龄、ASA分级、BMI、性别构成比无统计学差异(P>0.05)。G组患者手术期间的液体总量、胶体用量(130/0.4 6%的羟乙基淀粉)以及尿输出量高于C组(P<0.05)。血渗透压、出血量、输血量以及晶体用量(复方NaCl注射液用量)组间比较均无统计学差异(P>0.05)。两组患者都无脑水肿以及感染等并发症发生;G组的住院时间明显短于C组,差异有统计学意义(P<0.05)。G组在手术完成时(T3)的氧供指数(DO2I)、中心静脉血氧饱和度(ScvO2)、心指数(CI)、中心静脉压(CVP)以及平均血压(MBP)值均高于C组(P<0.05);G组患者T4血S100-β以及T3、T4血乳酸的浓度均低于C组患者(P<0.05);G组患者T3、T4时刻的血乳酸与S100-β浓度均比T1时刻低(P<0.05)。结论胶质瘤开颅术患者在麻醉过程中接受GDT治疗可以显著改善其预后的情况。
Objective Our retrospective study was aimed to discuss the effect of GDT dur- ing anaesthesia of patients with glioma craniotomy on prognosis,which offering theory evidence to the fluid management of patients in the Department of Neurosurgery. Methods Clinical data of 44 cases of patients with glioma craniotomy received treatment at our hospital from 2011 to 2014 was retrospectively analyzed. Patients included were divided into two groups according to the treatment,observe group （GDT） and control group （non--GDT）. Each group had 22 patients. The general information, blood osmotic pressure, fluid therapy protocols, the time of hospitalization, the incidence of postoperative complications, the related indexes, hemodynamics oxygen supply related index, the concentration of serum S100-- beta and blood lactic acidat different time. Results The age, gender, ASA staging, BMI and so on had no statistical difference. Comparing to control group, the total amount of liquid, colloidal, urine output all obviously increased in observe group. There was no statistical difference in blood osmotic pressure, blood loss, blood transfusion and crystal amount in two groups. None of patients occurred the postoperative complications in- cluding brain edema and infection. The time of hospitalization in observe group was obviously shorter than that in control group, the differences had statistical significance. The values of DO2I, ScvO2, CI, CVP and MBP in observe group at T3 were higher than those in control group. The level of S100-13at T4 and the levels of lactate at T3 and T4in observe group were lower than those in control group. The levels of S100-βand lactate at T3 and T4were all lower than those at T1 in observe group. Conclusion Patients with glioma craniotomy who treated with GDT in an aesthetic process can significantly improve the situation of prognosis.
出处
《立体定向和功能性神经外科杂志》
2015年第3期163-166,共4页
Chinese Journal of Stereotactic and Functional Neurosurgery
关键词
胶质瘤开颅术
目标导向液体治疗
预后
Glioma craniotomy
Goal-- directed fluid therapy （GDT）
Prognosis
