老年脊柱手术中应用每搏量变异度指导液体治疗对术后认知功能的影响

中华养生保健 ›› 2023, Vol. 41 ›› Issue (13): 1-4.

• 论著 • 下一篇

老年脊柱手术中应用每搏量变异度指导液体治疗对术后认知功能的影响

郝伟, 范惟^*, 王佳妮, 王超

内蒙古自治区人民医院麻醉科,内蒙古呼和浩特,010017

出版日期:2023-07-01 发布日期:2023-06-21
通讯作者: ^*范惟,E-mail：cnmgfwcnmgfw@163.com。
作者简介:郝伟（1980—）,女,汉族,籍贯：内蒙古自治区呼和浩特市,硕士研究生,副主任医师,研究方向：麻醉及相关药品对机体的影响及分子生物学机制。
基金资助:
内蒙古自治区卫生健康科技计划项目（202201003）; 内蒙古自然科学基金（2020LH08048）; 内蒙古自治区留学人员创新创业启动支持计划（2020-13）; 内蒙古自治区人民医院博士科研启动资金项目（2021BS02）

Influence of Stroke Volume Variation-guided Fluid Therapy on the Early Cognitive Function of Elderly Patients Following the Spinal Surgery

HAO Wei, FAN Wei^*, WANG Jia-ni, WANG Chao

Department of Anesthesiology, Inner Mongolia Autonomous Region People's Hospital,Hohhot Inner Mongolia, 010017, China

Online:2023-07-01 Published:2023-06-21

摘要/Abstract

摘要： 目的探究以每博量变异度为指导的液体疗法对老年脊柱患者术后早期认识功能的影响。方法抽取内蒙古自治区人民医院2020年2月—2021年2月收治的80例老年脊柱骨折患者作为研究对象,以随机抽样法为分组依据,分为研究1组（采用每博量变异度为指导的液体疗法）与研究2组（采用中心静脉血氧饱和度为指导的目标导向液体疗法）,各40例,对干预效果进行分析比较。结果研究1组全心舒张末期容积（GEDV）、心排指数（CI）、胸腔内血容量指数（ITBVI）高于研究2组,血管外肺水指数（EVLWI）、外周血管阻力（SVRI）低于研究2组,差异有统计学意义（P<0.05）。两组术前简易精神状态评定量表（MMSE）评分比较,差异无统计学意义（P>0.05）;研究1组术后6 h和术后24 h MMSE评分均高于研究2组,差异有统计学意义（P<0.05）。结论对老年脊柱患者采取以每搏量变异度为指导的液体疗法,可提升术后早期认知功能,此方法值得应用。

关键词: 老年脊柱手术, 每搏量变异度, 液体疗法, 认知功能

Abstract: Objective To study the influence of stroke volume variation-guided fluid therapy on the early cognitive function of elderly patients following the spinal surgery. Methods A total of 80 elderly patients of undergoing the spinal surgery from February 2020 to February 2021 in Inner Mongolia Autonomous Region People's Hospital were chosen as research samples. According to random sampling method, patients were divided into study group 1 (stroke volume variation-guided fluid therapy) and study group 2 (central venous oxygen saturation-guided fluid therapy), 40 cases in each group. The intervention effects were probed. Results The global end-diastolic volume (GEDV), cardiac index(CI)and intrathoracic blood volume index (ITBVI) in study group 1 were higher than those of study group 2, but extravascular lung water index (EVLWI) and systemic vascular resistance index(SVRI) were lower than those of study group 2 (P<0.05); before treatment, mini-mental state examination(MMSE) scores between groups were not significantly different(P>0.05), after 6 h and 24 h of treatment, MMSE scores in study group 1 were higher than those of study group 2 (P<0.05). Conclusion The stroke volume variation-guided fluid therapy can stabilize the hemorheology, improve the early cognitive function. It is worthy of clinical application.

Key words: pinal surgery for the elderly, stroke volume variation, fluid therapy, cognitive function

中图分类号:

R614

郝伟, 范惟, 王佳妮, 王超. 老年脊柱手术中应用每搏量变异度指导液体治疗对术后认知功能的影响[J]. 中华养生保健, 2023, 41(13): 1-4.

HAO Wei, FAN Wei, WANG Jia-ni, WANG Chao. Influence of Stroke Volume Variation-guided Fluid Therapy on the Early Cognitive Function of Elderly Patients Following the Spinal Surgery[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(13): 1-4.

参考文献

[1] 刘少中. 联合每搏输出量变异度与呼吸变异指数对重症脓毒症患者容量反应性的评估价值[J].临床急诊杂志,2018,19(9):617-619,623.
[2] 陆丹军,李娟,牛朝诗,等.每搏量变异度用于高血容量血液稀释患者容量监测的准确性[J].立体定向和功能性神经外科杂志,2018,31(3):175-178.
[3] 周美艳,王凯,宦乡,等.目标导向液体疗法对老年肺癌患者术后早期认知功能的影响[J].中国老年学杂志,2020,40(6):1221-1223.
[4] 张磊,孙昱,黄熠.以每搏量变异度为指导的目标导向液体疗法对结直肠癌手术患者消化系统的影响[J].医学临床研究,2019,36(2):282-284.
[5] 王朵朵,黄春霞,李云,等.术中不同补液疗法对脊柱手术患者术后谵妄的影响[J].天津医药,2021,49(1):64-68.
[6] 刘洋,田丹丹,张超凡,等.目标导向液体治疗对妇科腹腔镜手术术中血流动力学及脑氧饱和度的影响[J].临床麻醉学杂志,2020,36(4):349-353.
[7] 陆建强,张翊,刘晶.老年退行性脊柱侧弯患者经脊柱后路矫形内固定植骨融合术中大量失血的危险因素分析[J].浙江医学,2021,43(13):1424-1427.
[8] 吴永斌,晁丽娜,赵丽. 脑梗死患者rtPA静脉溶栓24 h后对给予双重抗血小板药物效果分析[J].宁夏医学杂志,2021,43(5):453-455.
[9] 何丽龙. 右美托咪定复合地佐辛静脉镇痛对老年腹部手术患者认知功能的影响[J].世界最新医学信息文摘(连续型电子期刊),2020,20(A2):217-218.
[10] 万海方,陶凡,赵杰,等.老年脊柱结核患者术后发生认知功能障碍的影响因素分析[J].中国防痨杂志,2021,43(5):441-445.
[11] JOOSTEN A, HAFIANE R, PUSTETTO M, et al.Practical impact of a decision support for goal-directed fluid therapy on protocol adherence: a clinical implementation study in patients undergoing major abdominal surgery[J]. Journal of clinical monitoring and computing,2019,33(1):15-24.
[12] HELLMUTH J, SLIKE B M, SACDALAN C, et al.Very Early Initiation of Antiretroviral Therapy During Acute HIV Infection Is Associated With Normalized Levels of Immune Activation Markers in Cerebrospinal Fluid but Not in Plasma[J]. The Journal of Infectious Diseases,2019,220(12):1885-1891.
[13] SOHN Y B, KO A R, SEONG M R, et al.The efficacy of intracerebroventricular idursulfase-beta enzyme replacement therapy in mucopolysaccharidosis II murine model: heparan sulfate in cerebrospinal fluid as a clinical biomarker of neuropathology[J]. Journal of inherited metabolic disease,2018,41(6):1235-1246.
[14] 陈志强. 目标导向液体治疗在幕上肿瘤切除术中的应用[D].广州:南方医科大学,2016.
[15] REGENMORTEL N V, VERBRUGGHE W, ROELANT E, et al.Maintenance fluid therapy and fluid creep impose more significant fluid, sodium, and chloride burdens than resuscitation fluids in critically ill patients: a retrospective study in a tertiary mixed ICU population[J].Intensive care medicine,2018,44(4):409-417.
[16] SHIM J W, KWAK J, ROH K, et al.Impact of intraoperative zero-balance fluid therapy on the occurrence of acute kidney injury in patients who had undergone colorectal cancer resection within an enhanced recovery after surgery protocol:a propensity score matching analysis[J].International journal of colorectal disease.,2020,35(8):1537-1548.
[17] 吴文庆. 术中液体治疗对髋膝关节手术患者外周白细胞反应的影响[D].广州:广州中医药大学,2012.
[18] 彭拓. 脓毒症患者初始液体复苏后ΔScvO2与容量反应性及微循环的相关性[D].湛江:广东医科大学,2020.
[19] 沙海旺,冯翀,王治国.左心室射血分数、颈内静脉呼吸塌陷指数对重症呼吸衰竭机械通气患者容量反应性的评估价值[J].医学临床研究,2019,36(11):2185-2187.
[20] RENNER J, CAVUS E, MEYBOHM P, et al.Stroke volume variation during hemorrhage and after fluid loading: impact of different tidal volumes[J]. Acta Anaesthesiol Scand,2007,51(5):538-544.

老年脊柱手术中应用每搏量变异度指导液体治疗对术后认知功能的影响

Influence of Stroke Volume Variation-guided Fluid Therapy on the Early Cognitive Function of Elderly Patients Following the Spinal Surgery

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