围手术期目标导向液体治疗的研究进展  

Research Progress of Perioperative Goal-directed Fluid Therapy

作　　者：王骜 章放香[1,2] 彭晶[2] 谢红春 WANG Ao;ZHANG Fangxiang;PENG Jing;XIE Hongchun(Guizhou Medical University,Guiyang 550025,China;Department of Anesthesiology,Guizhou Provincial People's Hospital,Guiyang 550002,China;Department of Anesthesiology,Liupanshui Shougang Shuigang General Hospital,Liupanshui 553000,China)

机构地区：[1]贵州医科大学,贵阳550025 [2]贵州省人民医院麻醉科,贵阳550002 [3]六盘水首钢水钢总医院麻醉科,贵州六盘水553000

出　　处：《医学综述》2021年第20期4058-4062,共5页Medical Recapitulate

基　　金：贵州省人民医院青年基金(GZSYQN〔2018〕13号);六盘水市科技计划项目(52020-2020-0-2-25)。

摘　　要：液体治疗是临床工作的重要组成部分,贯穿于围手术期治疗的全过程,适宜的液体管理可减少术后并发症发生、缩短住院时间,从而达到加速患者康复的目的。近年来随着对患者病理生理改变的深入了解、监测技术的增加,液体治疗方式从开放性液体治疗、限制性液体治疗向目标导向液体治疗(GDFT)转变。GDFT是通过监测患者特定的血流动力学指标,以判断患者对液体的需求,从而指导围手术期液体管理。GDFT在临床实践中表现出一定的积极作用,但目前尚无统一的液体治疗方案。未来通过综合考量患者、医疗及社会等多方面因素,GDFT在改善患者预后中发挥更重要的作用。Fluid therapy is an important part of clinical work,which runs through the whole process of perioperative treatment.Appropriate fluid management can reduce postoperative complications and shorten the length of hospital stay,so as to achieve the purpose of accelerating the recovery of the patients.In recent years,with the in-depth understanding of the pathophysiological changes of patients and the increase in monitoring technology,the fluid therapy mode has changed from liberal fluid therapy and restrictive fluid therapy to goal-directed fluid therapy(GDFT).GDFT is to monitor the patient's specific hemodynamic indicators to determine the patient's need for fluid,thereby guiding the perioperative fluid management.GDFT has shown a certain positive effect in clinical practice,but there is no unified fluid therapy program yet.In the future,GDFT will play a more important role in improving the prognosis from comprehensive consideration of the patient,medical and social factors.

关 键 词：目标导向液体治疗 围手术期 开放性液体治疗 限制性液体治疗 容量状态 

分 类 号：R459.9[医药卫生—治疗学]