目标导向灌注策略在心脏手术中的应用及研究进展  

Goal directed perfusion management in cardiac surgery

作　　者：章燕 周荣华[1] Zhang Yan;Zhou Ronghua(Department of Anesthesiology,West China Hospital of Sichuan University,Sichuan Chengdu 610041,China)

机构地区：[1]四川大学华西医院麻醉科,成都610041

出　　处：《中国体外循环杂志》2023年第4期241-245,共5页Chinese Journal of Extracorporeal Circulation

基　　金：四川省科技厅重点研发项目(2021YFS0195);国家自然科学基金资助项目(81970346);四川大学华西医院临床研究孵化项目(2018HXFH034)。

摘　　要：目标导向灌注(GDP),作为一种近年来提出的整合各种监测手段的个体化心肺转流(CPB)灌注策略,已越来越多地应用于心脏外科领域。具体是通过监测CPB期间氧供、氧耗、二氧化碳生成指数等氧代谢指标来指导血液稀释、灌注流量及血压管理,在提高CPB质量、降低心脏手术后并发症及改善患者预后中具有一定的价值。通过回顾近年相关临床研究,介绍GDP的基本概念、监测指标,并对GDP在心脏手术中的应用及研究进展进行综述,为其进一步的临床实施提供指导依据。Goal-directed perfusion(GDP),as an individualized cardiopulmonary bypass(CPB)perfusion strategy proposed in recent years,has been increasingly used in the field of cardiac surgery.It incorporates continuous monitoring of oxygen metabolism parameters,such as oxygen delivery,oxygen consumption,carbon dioxide production index to guide CPB dilution,pump flow and blood pressure management.GDP strategy can timely detect the whole-body hypoperfusion and anaerobic metabolism during CPB,which may result in reduced postoperative complications and improved patient outcome.By reviewing related clinical research in recent years,this narrative review is to provide a brief overview of GDP and its monitoring indicators,present the application and clinical researchers of GDP in cardiac surgery and provide guidance for its further clinical implementation.

关 键 词：目标导向灌注 心肺转流 心脏手术 氧供 氧耗 预后 

分 类 号：R654.2[医药卫生—外科学]