食道多普勒超声指导液体治疗在老年肺癌手术中的应用  

Application of Esophageal Doppler Ultrasound Guided Liquid Therapy in Elderly Lung Cancer Surgery

作　　者：陈鹏[1] 李玲 杨丽娜[1] 赵国娜[1] 姬雅君 CHEN Peng;LI Ling;YANG Lina;ZHAO Guona;JI Yajun(Cangzhou Central Hospital,Cangzhou 061000,Hebei,P.R.China)

机构地区：[1]沧州市中心医院,河北沧州061000

出　　处：《影像科学与光化学》2022年第1期119-123,共5页Imaging Science and Photochemistry

基　　金：河北省医学科学研究课题计划(20200317)。

摘　　要：本研究探讨经食管超声心动图(TEE)指导液体治疗在老年肺癌根治术患者术中的应用价值。选取我院心胸外科实施传统肺癌手术患者98例,采用前瞻性研究方案,依据随机数字将患者分为TEE组(TEE指导下液体治疗)和常规组(传统方法补充液体治疗)各49例,两组患者均采用传统开胸手术治疗,对比两组患者的血流动力学参数、补充液体量、氧合指数、血乳酸水平、术后手术并发症指标。结果显示,TEE组的晶体液用量、胶体液用量均低于常规组(P<0.05);监测对比TEE组和常规组患者在T1~T4时刻的血流动力学参数,TEE组在T2、T3时刻的每搏变异度(SVV)、中心静脉压(CVP)测定值明显低于常规组(P<0.05);TEE组的心排血量(CO)值在T4时刻高于常规组(P<0.05);TEE组的平均动脉压(MAP)值在T3、T4时刻明显低于常规组(P<0.05);术中60 min、术后30 min时,TEE组的氧合指数明显高于常规组,血乳酸明显低于常规组(P<0.05)。老年肺癌根治术患者采用TEE指导液体治疗,有利于维持患者血流动力学指标的稳定性,能更好地维持外周血循环及组织灌流。This study explored the application value of transesophageal echocardiography(TEE) guided fluid therapy in elderly patients undergoing radical resection of lung cancer. A total of 98 patients undergoing traditional lung cancer surgery were selected. Based on a prospective research program, the patients were divided into TEE group(liquid treatment under the guidance of TEE) and conventional group(liquid supplementation with traditional methods), 49 cases each. Both groups of patients were treated with traditional thoracotomy, and the hemodynamic parameters, supplementary fluid volume, oxygenation index, blood lactic acid level, and postoperative complications of the two groups were compared. The dosage of crystalloid and colloidal fluid in the TEE group was lower than that in the conventional group(P<0.05);the hemodynamic parameters of the TEE group and the conventional group were monitored and compared at T1 to T4. The measured values of stroke variability and central venous pressure were lower than those of the conventional group;cardiac output(CO) value of TEE group was higher than that of conventional group at T4(P<0.05);mean arterial pressure value of TEE group was lower than that of conventional group at T3 and T4. At 60 min during the operation and 30 min after the operation, the oxygenation index of the TEE group was higher than that of the routine group,and the blood lactate was lower than that of the routine group(P<0.05).Elderly patients undergoing radical resection of lung cancer use TEE-guided fluid therapy,which helps maintain the stability of the patient′s hemodynamic indicators,and can better maintain the peripheral blood circulation and tissue perfusion.

关 键 词：老年 肺癌根治术 经食管超声心动图 液体治疗 

分 类 号：R734.2[医药卫生—肿瘤]