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- Title
目标导向液体管理策略对脑肿瘤切除术患者血乳酸水平、血流动力学及认知功能的影响.
- Authors
周立民; 王彩霞; 李国华; 任杰; 李俊; 张文生
- Abstract
Objective: To explore the effect of goal-directed fluid management strategy on blood lactate level, hemodynamics and cognitive function in patients undergoing brain tumor resection. Methods: 110 patients who underwent brain tumor resection in The Second Affiliated Hospital of Shandong First Medical University from January 2016 to October 2019 were selected, they were randomly divided into two groups: study group and control group, 55 patients in each group. The patients in the study group received the goal-directed fluid management, while the patients in the control group received the routine infusion management. The amount of crystal fluid, colloid fluid, total amount of infusion, blood loss and urine volume of the two groups were observed. Arterial lactate (aLac), venous lactate (vLac), arteriovenous lactate difference (△ Lac), brain lactate production rate (Lac PR) and hemodynamic level were observed before anesthesia induction (T0), at the time of endotracheal intubation (T1), at the time of dural incision (T2) and at the end of operation (T3). The results of MMSE were compared between the two groups before operation, one day after operation, three days after operation and seven days after operation. Results: The dosage of colloid solution, total amount of infusion and urine volume in the study group were significantly higher than those in the control group (P<0.05). The aLac, vLac, △ Lac, Lac PR in T1, T2 and T3 time points of the study group were significantly lower than those in the control group(P< 0.05). The cardiac index(CI), mean arterial pressure(MAP) and arterial oxygen content(CaO2) of the T3 time point study group were significantly higher than those of the control group, and MMSE score of the study group was significantly higher than that of the control group 1d, 3d and 7d after surgery(P<0.05). Conclusion: Target directed fluid management can reduce the blood lactate level, improve the hemodynamics, and reduce the influence of surgery and anesthesia on the cognitive function of patients.
- Subjects
BLOOD lactate; BRAIN tumors; TUMOR surgery; COGNITIVE ability; TRACHEA intubation
- Publication
Progress in Modern Biomedicine, 2021, Vol 21, Issue 20, p3927
- ISSN
1673-6273
- Publication type
Article
- DOI
10.13241/j.cnki.pmb.2021.20.025