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- Title
GDFT 联合小剂量甲氧明在胸腹联合腔镜食管癌根治术中的应用.
- Authors
李珊珊; 杨 会; 吕振超; 赵 敏; 刘光顺; 王忠慧
- Abstract
Objective To compare the effects of two fluid management regimens, goal-directed fluid therapy( GDFT) and restrictive fluid therapy, on patients undergoing thoracoabdominal combined endoscopic esophagectomy for esophageal cancer in the context of prophylactic intravenous pump infusion of low-dose methoxamine 1.0 ~2.5 μg/( kg·min), in order to provide more optimal fluid management for such patients. Methods Thirty-six patients were scheduled to undergo thoracoabdominal combined with laparoscopic radical esophagectomy fore sophageal cancer were divided into goal-directed liquid therapy group (Group G) and restrictive liquid therapy group (Group R) according to random number table method. Group G patients were managed with SVV value of 8%~10%,CI > 2.5 L/(min·m2)as the target. The restrictive infusion regimen was used in group R. HR, MAP, SVV, CO, CI and SV were monitored and recorded before anesthesia induction( T0), after anesthesia induction (T1),two lung ventilation for 15 min(T2),one lung ventilation for 15 min(T3),two lung ventilation for 15 min( T4) after lung recruitment and operation completion( T5); intraoperative infusion volume, crystalloid volume, colloid volume, urine volume, blood loss, the usage of methoxamine and the occurrence of early postoperative complications were recorded. Results At the time points of T4 and T5,the HR of group G was lower than that of group R, and the difference was statistically significant (P < 0.05). The MAP,SVV,CO,CI and SV of group G were higher than those of group R, and the difference was statistically significant (P < 0.05). In terms of fluid intake and output, the total fluid volume in group G was less than that in group R, in which the decrease of crystalloid fluid was the main factor, and the difference was statistically significant( P < 0.05),while the colloidal fluid volume in group G was more than that in group R, the difference was statistically significant (P < 0.05);the intraoperative urine volume in group R was significantly more than that in group G, and the difference was statistically significant (P < 0.05). In terms of complications, the incidence of postoperative nausea and vomiting, cough and expectoration in group G was lower than that in group R. The difference of the pain complications was statistically significant (P < 0.05). Conclusion GDFT combined with low-dose methoxamine is more suitable for fluid management in patients undergoing thoracoabdominal combined laparoscopic esophagectomy for esophageal cancer.
- Publication
Journal of Kunming Medical University / Kunming Yike Daxue Xuebao, 2020, Vol 41, Issue 11, p72
- ISSN
2095-610X
- Publication type
Academic Journal
- DOI
10.12259/j.issn.2095-610X.S20201105