目的：比较采用FloTrac／Vigileo系统进行目标导向性容量治疗和传统的补液方法对全麻下行骨水泥固定型全髋关节置换手术的老年患者术中循环状况及术后并发症的影响。方法全麻下行骨水泥固定型全髋关节置换手术的老年患者40例，采用随机数字表法分为V组和对照组。对照组组采用常规补液方案进行补液；V组采用FloTrac／Vigileo系统监测血流动力学指标，依据每搏量变异度（SVV）、中心静脉压（CVP）、心指数（CI）指导的目标管理补液方案进行补液。记录术中输液量、失血量、尿量以及术中血流动力学不良事件和术后并发症情况。结果 V组患者术中血压的波动更小，且术中血流动力学不良事件和术后并发症低于对照组。两组患者术中液体总输入量没有差异，但V组晶体输入量低于对照组，胶体的输入量高于对照组。结论采用FloTrac／Vigileo系统以SVV、CI、CVP为目标的补液方案能更好地维持全麻下骨水泥固定型全髋关节置换术中血流动力学的平稳，减少术后并发症，是比传统补液方案更为理想的容量治疗方案。%Objective To compare the effects of goal-directed fluid therapy with FloTrac/Vigileo system to that of conventional fluid therapy during elective total hip arthroplasty on circulation and postoperative complications in elder patients.Methods Forty pa-tients undergoing total hip replacement were randomly divided into control group and vigileo group( V group) .Patients in the V group were connected to the FloTrac sensor/Vigileo monitor haemodynamic monitoring system in addition to standard monitoring.Fluid therapy was guided in accordance to SVV,CI and CVP.In the control group conventional fluid therapy was administrated.Amount of infusion, blood loss and urine volume were recorded.The complications of hemodynamics and postoperative adverse events were also observed. Results Fluctuations of blood pressure,complications of hemodynamics and postoperative adverse events in the V group were less than that in the control group.Although there was no difference in infusion volume between the two groups, the group V received more colloids but less crystal transfused than the control group did.Conclusion Goal-directed fluid therapy during general anesthesia in pa-tients undergoing elective total hip replacement can keep hemodynamics steady and improve patient outcomes by decreasing postopera-tive complications.
展开▼
