目标导向血流动力学管理策略在自体心包主动脉瓣重建术中的应用  

Application of Goal-oriented Hemodynamic Management Strategy in Autologous Pericardial Aortic Valve Reconstruction

作　　者：蒋斌[1] 刘永春[1] JIANG Bin;LIU Yongchun(Nanning First People's Hospital,Nanning 530021,China)

机构地区：[1]南宁市第一人民医院,广西南宁530021

出　　处：《中外医学研究》2021年第8期178-181,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：南宁市科学研究与技术开发计划项目(20193099)。

摘　　要：目的:目标导向血流动力学管理策略在自体心包主动脉瓣重建术中的应用效果。方法:将2017年8月-2020年8月于笔者所在医院行自体心包主动脉瓣重建术的60例患者按照随机数字表法分为对照组(n=30,采用常规液体管理措施)和观察组(n=30,在对照组基础上采用目标导向血流动力学管理策略)。比较两组术中液体出入量(液体入量、万汶输入量、液体出量、林格氏液输入量、尿量、出血量),比较两组术后恢复指标[机械通气时间、ICU(重症加强护理病房)留驻时间、住院时间]及术后2 d内并发症发生情况。结果:观察组万汶输入量、液体出量、尿量均多于对照组,观察组林格氏液输入量少于对照组,差异均有统计学意义(P<0.05),两组液体入量、出血量比较差异均无统计学意义(P>0.05);观察组ICU留驻时间、住院时间均短于对照组,差异均有统计学意义(P<0.05),两组机械通气时间比较差异无统计学意义(P>0.05);术后2 d内,观察组消化功能紊乱、急性肾损伤发生率均低于对照组,差异均有统计学意义(P<0.05),两组切口感染、肺部感染、心肌梗死发生率比较差异无统计学意义(P>0.05)。结论:自体心包主动脉瓣重建术中运用目标导向血流动力学管理策略可显著接近患者术后恢复,减少术后并发症发生风险,对其预后康复有利。Objective:To explore the application effects of goal-oriented hemodynamic management strategy in autologous pericardial aortic valve reconstruction.Method:Sixty patients who underwent autologous pericardial aortic valve reconstruction in our hospital between August 2017 and August 2020 were divided into the control group(n=30,given conventional fluid management measures)and the observation group(n=30,given goal-oriented hemodynamic management strategy on the basis of control group)according to the random number table method.The intraoperative fluid input and output(fluid input,Voluven input,fluid output,Ringer's fluid input,urine output,blood loss)were compared between the two groups.The postoperative recovery indicators[mechanical ventilation time,ICU(intensive care unit)stay,hospital stay]and occurrence of complications within 2 d after surgery were compared between the two groups.Result:The input volume of Voluven,liquid output and urine volume in the observation group were more than those in the control group,while the input volume of Ringer's fluid in the observation group was less than that in the control group,the differences were statistically significant(P<0.05),there was no statistical significance in the fluid intake and blood loss between the two groups(P>0.05).The duration of ICU stay and hospital stay in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05),and there was no significant difference in mechanical ventilation time between the two groups(P>0.05).Within 2 days after operation,the incidence of digestive dysfunction and acute kidney injury in the observation group was lower than that in the control group,the differences were statistically significant(P<0.05),there was no significant difference in the incidence of incision infection,pulmonary infection and myocardial infarction between the two groups(P>0.05).Conclusion:Goal-oriented hemodynamic management strategy during autologous pericardial aortic valve reconstruction

关 键 词：目标导向血流动力学管理策略 自体心包主动脉瓣重建术 液体出入量 并发症 

分 类 号：R654.2[医药卫生—外科学]