摘要
Abstract
Objective To explore the effect of fluid resuscitation guided by axillary vein collapse index under ultrasound guidance on the delirium in elderly patients undergoing laparoscopic cholecystectomy.Methods A total of 101 elderly patients who underwent e-lective laparoscopic cholecystectomy at the First Hospital of Shanxi Medical University from February 2025 to May 2025 were selected and randomly divided into an experimental group(n=51)and a control group(n=50).The experimental group received fluid resus-citation guided by axillary vein collapse index,while the control group received conventional fluid resuscitation.The mean arterial pres-sure(MAP)and heart rate(HR)were recorded at T0(before anesthesia),T1(5 minutes after anesthesia),T2(at the start of surger-y),T3(30 minutes after the start of surgery),and T4(at the end of surgery).The preoperative and postoperative lactate values(Lac),recovery time,total fluid volume,ephedrine usage,and incidence of intraoperative hypotension were recorded.The incidence of postoperative delirium,MMSE scores at T5(1 hour after surgery),T6(24 hours after surgery),and T7(48 hours after surgery),postoperative pain scores at 24 hours,time to first ambulation,time to first flatus,hospital stay,and incidence of postoperative nausea and vomiting were also recorded.Adverse reactions in the respiratory and cardiovascular systems were recorded.Results Compared with the control group,the MAP in the experimental group increased at T1(P<0.05),the postoperative Lac concentration decreased(P<0.05),the total fluid volume decreased(P<0.05),and the incidence of hypotension and the usage of vasoactive drugs were sig-nificantly reduced(P<0.05).At T5,the MMSE score of the experimental group increased significantly(P<0.05),the incidence of delirium decreased(P<0.05),the incidence of postoperative nausea and vomiting decreased significantly(P<0.05),and the time to first ambulation and first flatus decreased(P<0.05).In the subgroup with normal cognitive function,compared with the control group,the VAS score of the experimental group was significantly low-er,and all these differences were statistically significant(P<0.05).Conclusions Compared with conventional fluid resuscitation,fluid resuscitation guided by axillary vein collapse index under ultrasound guidance can reduce the incidence of postoperative delirium in eld-erly patients undergoing laparoscopic cholecystectomy,decrease the incidence of intraoperative hypotension,improve postoperative pain and gastrointestinal function,and improve the early prognosis of patients.关键词
腋静脉塌陷指数/苏醒期谵妄/液体管理/胆囊切除术Key words
axillary vein collapse index/delirium during awakening period/fluid management/cholecystectomy分类
医药卫生
