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在高度质瘤切除患者的手术内目标导向液体管理和术后脑:一项随机试验
Xiaoyuan Liu1, Xingyue Zhang2, Yifang Fan1
1Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University.
International journal of surgery (London, England)
|July 22, 2024
概括
目标导向的液体治疗显著减少了脑瘤患者的液体体积,但没有减少手术后脑. 这种方法虽然在流体管理方面有效,但没有影响脑的结果.
科学领域:
- 神经外科 神经外科
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
背景情况:
- 高度质瘤经常导致严重的大脑胀.
- 已知以目标为导向的流体管理可以保护神经功能.
- 它对减少手术后脑的作用尚未得到充分证实.
研究的目的:
- 为了调查是否目标导向的流体管理减少了手术后脑 edem 在患者接受选拔切除 supratentorial 恶性结质瘤.
- 为了比较目标定向和例行流体管理之间的流体体积和手术内持续紧张.
主要方法:
- 随机对照试验涉及480名患有 supratentorial恶性质瘤的患者.
- 目标导向组在中风体积变化超过15%时接受基乙烯粉,持续5分钟.
- 常规流体管理由临床麻醉师进行.
- 主要结局:通过CT扫描评估的手术后脑体积.
主要成果:
- 在目标导向小组中显著降低晶化物,合物和整体液体平衡.
- 两组之间手术后脑 edem 容量没有显著差异 (36.0 vs 38.9 cm3).
- 在目标导向组中观察到较低的手术内持续紧张 (RR: 0.63,P < 0.001).
结论:
- 目标导向的液体治疗有效地减少了脑瘤切除中的静脉注射液体.
- 这种液体管理策略并不能显著减少手术后脑.
- 可能需要进一步的研究来探索减少的替代方法.
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