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个性化血液动力学优化使用中风量,脉冲压变化和持续心脏指数在主要肝脏手术:一个随机对照试验

Francisco Javier Redondo Calvo^1,2,3, Víctor Baladrón González^1,2, David Padilla Valverde^2,4

¹Department of Anesthesiology and Critical Care Medicine, University General Hospital, 13004 Ciudad Real, Spain.

Journal of personalized medicine

|October 28, 2025

概括

与传统护理相比,个性化的目标导向血液动力学疗法在重大肝切除过程中显著减少了血液损失和液体的输送. 这种方法优化了肝脏手术中的患者结果.

科学领域:

麻醉学麻醉学
肝胆道手术肝胆道手术
关键护理医学关键护理医学

背景情况:

大型肝切除涉及显著的液体转移和出血风险.
优化术后流体管理对于患者的安全和结果至关重要.
目前的液体输送策略可能无法为复杂的手术提供足够的个性化服务.

研究的目的:

评估个性化目标导向血液动力学疗法 (GDHT) 对液体输送和手术内出血的影响.
以放射性动脉脉冲轮分析为指导的GDHT与主要肝切除患者的传统护理进行比较.

主要方法:

未来的,随机的,平行组试验,涉及经过肝切除的大型切除的成年患者.
干预组使用ProAQTTM监视器接受GDHT,以中风体积,脉冲压变化 (SVV,PPV) 和心脏指数 (CI) 为指导.
对照组接受了传统的术后护理.

主要成果:

与对照组 (728.13 ± 618.59毫升) 相比,GDHT组的血液损失显著减少 (292.63 ± 274.06毫升) (p = 0.009).
较少的GDHT组患者需要进行手术前输血 (p = 0.005).
在GDHT组 (1125.79±751.2毫升) 与对照组 (2853.13±1432.18毫升) 相比,手术内流体输液总量显着较低 (p = 0.001).

结论:

个性化目标导向疗法有效优化了在主要肝切除期间的手术内液体的管理.
在这种患者群体中,GDHT显著降低了手术内出血和输血的需要.
辐射动脉脉冲轮分析是指导肝脏手术中的血液动力学管理的宝贵工具.

关键词:

以目标为导向的血液动力学治疗.在手术期间出现血流.脉冲压力变化的变化切除肝脏切除肝脏切除动脉冲动量变化的变化

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