患有结直肠癌的老年患者的术后认知功能障碍:一项随机对照研究,比较了目标导向和传统流体治疗
Bin Wu1, Yuanyuan Guo1, Su Min2
1Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, People's Republic of China.
Open medicine (Warsaw, Poland)
|April 8, 2024
概括
目标导向的流体治疗 (GDFT) 在老年结肠直肠癌患者中显著降低了术后认知功能障碍 (POCD). 这种方法也改善了恢复和减少并发症.
科学领域:
- 麻醉学和外科手术期间的医学.
- 在瘤学瘤学.
- 老年病的医生 老年病的医生
背景情况:
- 手术后认知功能障碍 (POCD) 是接受重大手术的老年患者的一个重大问题.
- 结肠直肠癌手术,特别是腹腔镜彻底切除,会带来认知障碍的风险.
- 优化外科周流体管理可以减轻这些风险.
研究的目的:
- 评估目标导向液体疗法 (GDFT) 在预防老年结直肠癌患者的POCD中的有效性.
- 为了比较GDFT与传统的流体治疗关于POCD发病率和相关结果.
- 评估GDFT对炎症标志物,血液动力学和功能恢复的影响.
主要方法:
- 一项随机对照试验,涉及80名老年患者,接受了选择性腹腔镜结直肠癌切除术.
- 患者被分配到GDFT或常规流体治疗组.
- 结果包括POCD发病率,炎症标志物 (IL-6,S100β),血液动力学,乳酸水平,功能恢复和并发症.
主要成果:
- 在GDFT组中,POCD的发病率明显较低 (15.0%) 与传统组相比 (30.0%).
- GDFT与较低的IL-6和S100β水平,更稳定的血液动力学和降低的乳酸水平有关.
- 接受GDFT治疗的患者经过手术后的功能恢复得到改善,并发症减少.
结论:
- 目标导向的流体治疗有效地减少了接受结肠直肠癌手术的老年患者早期POCD的发生率.
- GDFT有助于更好的术后稳定性,更快的功能恢复,以及改善整体预后.
- 像GDFT这样的流体管理策略对于优化脆弱手术群体的结果至关重要.
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