安徽医科大学学报2017，Vol.52Issue(2)：273-277,5.DOI:10.19405/j.cnki.issn1000-1492.2017.02.028
经食道超声多普勒指导的目标导向液体治疗在活体肾移植术中的应用
Application of goal-directed fluid therapy directed by transesophageal Doppler in patients undergoing living donor renal transplant surgery
摘要
Abstract
Objective To observe the application of goal-directed fluid therapy directed by transesophageal Doppler ( TED) in patients undergoing living donor renal transplant surgery. Methods 100 patients undergoing living donor renal transplant surgery, ASA Ⅲ~Ⅳ,were randomly divided into routine fluid therapy group(group CVP) and goal-directed fluid therapy group monitered with TED( group TED) using random digits table. Hemodynamic param-eters of two groups were recorded before anesthesia(T0),10 minutes after induction of anesthesia(T1), before o-pening of renal artery( T2 ) ,15 minutes after opening renal artery( T3 ) and the end of surgery( T4 ) . The amount of bleeding, infusion fluid and operative time were recorded. Urea nitrogen, creatinine, urine outputs were recorded before surgery and on days 1, 2, 4, 10 and at 1 and 3 months after surgery. Results The MAP of both groups at T3 were lower than before anesthesia(P<0. 01),the CVP of group TED was higher than group CVP at the point of T2,T3 and T4(P<0. 05). The amount of intraoperative fluid given in group TED was lower than in group CVP(P<0. 01 ) . Side-effects like postoperative dyspnoea and tissue edema were higher in group CVP. The postoperative graft function was comparable. Conclusion TED-guided intraoperative fluid therapy achieve the same rate of immediate graft function as CVP-guided fluid therapy but use a significantly less amount of fluid. The incidence of postopera-tive complications related to fluid overload is also reduced.关键词
经食道超声多普勒/目标导向液体治疗/肾移植/每搏输出量Key words
transesophageal Doppler/goal-directed fluid therapy/renal transplant/stroke volume分类
医药卫生引用本文复制引用
闫文龙,疏树华,柴小青,王迪,高亚利,刘洪涛,叶剑锋..经食道超声多普勒指导的目标导向液体治疗在活体肾移植术中的应用[J].安徽医科大学学报,2017,52(2):273-277,5.基金项目
安徽省卫生厅医学科研课题(编号:13zc027) （编号:13zc027）
