目标导向液体治疗对老年高血压患者行控制性降压鼻内镜手术血乳酸指标的影响  

The Effect of Goal-oriented Fluid Therapy on Blood Lactic Acid Indexes in Elderly Hypertensive Patients Undergoing Controlled Hypotension Endoscopic Sinus Surgery

作　　者：王军[1] 高刚[1] 沈倪美[1] 季超[1] WANG Jun;GAO Gang;SHEN Nimei;JI Chao(Department of Otorhinolaryngology Head and Neck Surgery,Nantong First People's Hospital,Nantong,Jiangsu Province,226001 China)

机构地区：[1]南通市第一人民医院耳鼻喉头颈外科,江苏南通226001

出　　处：《系统医学》2021年第21期132-135,共4页Systems Medicine

基　　金：南通市科技计划指导性项目(GJZ17111)。

摘　　要：目的探究老年高血压患者行控制性降压鼻内镜手术中应用目标导向液体治疗对患者乳酸指标的干预价值。方法选取该院2018年5月—2021年5月收治的实施鼻内镜手术的老年高血压患者80例,应用双盲分配模式分为两组,分析组及参比组,每组40例。分析组采取目标导向液体治疗,参比组采用常规液体治疗,对比分析患者不同时间的组织灌注血流动力学指标、脑氧饱和度指标、血乳酸指标、炎性因子指标、并发症发生率。结果两组患者T4、T5时间段内MAP、心率指标比较,差异有统计学意义(P<0.05);参比组T2、T3时脑氧饱和度低于分析组,T4、T5时间段乳酸值高于分析组,T2、T3、T4、T5时期TNF-α指标高于分析组,差异有统计学意义(P<0.05);分析组并发症发生率2.50%低于参比组37.50%,差异有统计学意义(χ^(2)=15.312,P<0.05)。结论实施鼻内镜手术的老年高血压患者中应用目标导向液体治疗可保证患者的血流动力学指标稳定,预防乳酸升高,使患者机体炎性反应降低,降低并发症发生率。Objective To explore the intervention value of target-oriented liquid therapy in elderly hypertensive patients.Methods To study the clinical data of elderly hypertensive patients undergoing nasal endoscopic surgery admitted to the hospital during May 2018 to May 2021,80 cases were randomly selected,and the double-blind allocation model was used to divide them into two groups,an analysis group and a reference group,with 40 cases in each group.The analysis group adopted goal-oriented liquid therapy,and the reference group adopted conventional liquid therapy.The patients'tissue perfusion hemodynamic indexes,cerebral oxygen saturation indexes,blood lactic acid indexes,inflammatory factors indexes,and complication rate were compared and analyzed at different times.Results There was a statistically significant difference in MAP and heart rate indexes between the two groups of patients in the T4 and T5 time periods(P<0.05);the cerebral oxygen saturation at T2 and T3 in the reference group was lower than that in the analysis group,and the lactic acid value in the T4 and T5 time period was higher in the analysis group,the TNF-αindex at T2,T3,T4,and T5 was higher than that in the analysis group,and the difference was statistically significant(P<0.05);the complication rate of the analysis group was 2.50% lower than that of the reference group 37.50%,and the difference was statistically significant(χ^(2)=15.312,P<0.05).Conclusion The application of target-oriented liquid therapy in elderly patients with nasal endoscopic surgery can ensure the stability of the hemodynamic index,prevent elevated lactic acid,reduce the inflammatory response and reduce the incidence of complications.

关 键 词：老年高血压 目标导向液体治疗 乳酸值 控制性降压 

分 类 号：R614[医药卫生—麻醉学]