压力记录分析法指导的目标导向液体治疗在脑肿瘤切除术中的应用

 目的 探讨压力记录分析法(pressure recording analytical method,PRAM)指导的目标导向液体治疗在脑肿瘤切除术中的应用。方法 选择择期行脑肿瘤切除术的患者40例,随机分为两组,试验组以PRAM技术获得的血流动力学参数指导目标导向液体治疗(GDFT组,G组),对照组以传统静态参数指导输液治疗(C组),每组20例。记录手术期间液体总入量、晶体液入量、胶体液入量、库血输入量、尿量、出血量、血管活性药物的使用情况,并记录麻醉诱导前(T₀)、麻醉诱导后手术前(T₁)、手术切皮时(T₂)、肿瘤切除后(T₃ )、关颅完毕(T₄)的血流动力学变化。结果 与C组比较,G组液体总入量、胶体液入量和尿量明显增加(P<0.05)。T₂-T₄ 时G组MAP明显高于C组(P<0.05)。结论 PRAM指导的目标导向液体治疗能有效优化脑肿瘤切除患者术中的容量状况,维持围术期血流动力学稳定。

Goal-directed fluid therapy in intracranial tumor resection guided by pressure recording analytical method

Objective To evaluate the goal-directed fluid therapy guided by pressure recording analytical method (PRAM) in intracranial tumor resection.Methods Forty patients undergoing intracranial tumor resection were randomly divided into two groups: goal-directed fluid therapy group(Group G) and the traditional fluid therapy group(Group C). Group G received the goal-directed fluid therapy based on SVV, whereas group C was treated with a traditional fluid therapy based on CVP, MAP and the urinary output. The crystalloid requirements, colloid requirements, banked blood requirements, total fluid volume infused ,urinary output, bleeding volume,vasoactive drugs and hemodynamics during operation were recorded.Results The colloid volume, total fluid volume infused,and urinary output during operation were significantly larger in group G than in group C(P<0.05), so was MAP at T₂-T₄(P<0.05).Conclusions PRAM guided goal-directed fluid therapy can help optimize the capacity state in intracranial tumor resection patients and maintain the perioperative stability of hemodynamics .