目标导向液体治疗在经皮肾镜碎石取石术中的应用观察  

Clinical observation of goal-directed fluid therapy in percutaneous nephrolithotomy

作　　者：刘民强[1] 何仁亮[1] 张定 钟祥鹏 李志超[1] 胡红星[2] LIU Minqiang;HE Renliang;ZHANG Ding;ZHONG Xiangpeng;LI ZHICHAO;HU Hongxing(Department of Anesthesiology,Shenzhen Third People's Hospital,Shenzhen,Guangdong 518112,China;Department of Urology,Shenzhen Third People's Hospital,Shenzhen,Guangdong 518112,China)

机构地区：[1]广东省深圳市第三人民医院麻醉科,518112 [2]广东省深圳市第三人民医院泌尿外科,518112

出　　处：《重庆医学》2019年第A01期49-51,共3页Chongqing medicine

基　　金：深圳市卫生计生系统科研项目(SZFZ2018058)。

摘　　要：目的观察目标导向液体治疗(GDFT)在经皮肾镜碎石取石术(PCNL)中的临床效果。方法择期行PCNL患者40例,随机分为观察组(O组)和对照组(C组),每组20例,所有患者都采用气管插管全身麻醉,O组术中采用GDFT策略,C组采用“4-2-1”法则。观察两组患者围术期并发症发生情况、术中总输液量、出血量、输血量、拔管时间及离室时间。结果与C组相比,O组围术期总输液量明显下降(P<0.01),循环系统总并发症及术后苏醒延迟发生率较低(P<0.05)。结论PCNL中采用GDFT可减少输液量,为患者提供更稳定的血流动力学,并有助于缩短手术时间,提高苏醒质量。Objective To observe the clinical effects of goal-directed fluid therapy (GDFT) in patients under percutaneous nephrolithotomy (PCNL). Methods Forty ASA grade Ⅱ or Ⅲ patients received selective PCNL were included.All of them received general anesthesia,and were randomly divided into observation group (group O) and control group (group C) with twenty cases each.The transfusion program was guided by GDFT in group O,but a restrictive infusion therapy was administered in group C.The complications during the peri-operative period were recorded,the total infusion amount,the bleeding volume,the amount of blood transfusion,the usage of vasoactive agent,the extubation time,and the leaving time between two groups were also observed. Results Compared with the C group,the total infusion volume in group O was significantly decreased ( P <0.01),and the total incidence of circulatory system complications and recovery delayed were lower ( P <0.05),but there were no significant differences in other complications and postoperative recovery between the two groups ( P >0.05). Conclusion The strategy of GDFT used in PCNL can help reducing the volume of transfusion,providing more stable hemodynamics,shortening the operation time,and improving the quality of recovery.Thus it is a better infusion program.

关 键 词：目标导向液体治疗 经皮肾镜碎石取石术 并发症 

分 类 号：R692.4[医药卫生—泌尿科学]