围术期目标导向液体治疗策略与进展  

Strategies and Progress of Perioperative Goal-Directed Fluid Therapy

作　　者：于霜霜 赵晓春[1] YU Shuangshuang;ZHAO Xiaochun(Department of Anesthesiology,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院麻醉科,沈阳110004

出　　处：《医学综述》2018年第21期4286-4291,共6页Medical Recapitulate

摘　　要：液体管理是围术期最常见的问题之一。传统治疗方法按照开放性补液原则,结合患者的血压、心率、尿量和中心静脉压等指标进行输液指导,易发生容量负荷过多、组织水肿等不良事件;限制性液体治疗方法则易出现循环血量不足、血流动力学不稳定、组织灌注差等情况。目标导向液体治疗旨在为患者提供更加个体化、精确化、合理化的补液方案,以维持围术期的血流动力学稳定,保证组织充分恰当的灌注,减少心血管不良事件及远期并发症的发生。为达到这样一个理想状态,准确、简便、微创甚至无创的监测设备和指导方案逐渐被开展。未来,将在血管紧张度和微循环功能障碍监测方面进一步发展。Liquid management is one of the most common problems in the perioperative period.According to the principle of open rehydration and combined with the indexes of patient′s blood pressure,heart rate,urine volume and central venous pressure,the traditional treatment is prone to excessive volume loading,tissue edema and other adverse events; Restrictive liquid method is prone to circulatory insufficiency,hemodynamic instability,poor tissue infusion and so on.Goal-directed fluid therapy aims to provide patients with more individualized, precise and scientific therapy to maintain the hemodynamic stability in perioperative period,ensure adequate tissue perfusion,and reduce cardiovascular adverse events and long-term occurrences.In order to achieve such an ideal state,accurate,simple,minimally invasive even non-invasive monitoring techniques and strategies are gradually carried out. In the future, further development will be made in the monitoring of vascular tone and microcirculatory dysfunction.

关 键 词：目标导向液体治疗 围术期 监测方法 血流动力学 组织氧供与代谢 

分 类 号：R614[医药卫生—麻醉学]