不同目标导向液体治疗对亲属活体肾移植受体术后近期肾功能的影响 : = Effect of different target-directed fluid therapy on recent renal function in living-related renal transplantation recipients
目的通过观察以中心静脉压(CVP)、尿量和每搏变异度(SVV)、心排量(CO)不同目标导向液体治策略对亲属活体肾移植受体术后近期肾功能的影响,探讨不同目标导向液体治疗在肾移植手术中的临床意义。方法选择择期亲属活体肾移植受体患者100例,年龄18～55岁,体质量50～80 kg,ASA分级Ⅲ～Ⅳ级,每组50例,随机分为以CVP和尿量为导向的传统补液组(C组)和以SVV、CO为导向的SVV组(SVV组)。两组患者常规行ECG、SpO_2、有创动脉血压、CVP监测。SVV组应用FloTrac/Vigileo监测SVV、CO等参数。记录麻醉诱导前(T_0),手术开始后30 min(T_1),肾动脉开放前5 min(T_2),肾动脉开放后5 min(T_3),肾动脉开放后30 min(T_4),手术结束时(T_5)血流动力学参数,手术时间、术中输液量、出血量、尿量,围术期血管活性药物使用比例及住院天数,记录术后1、2、3 d的尿量和输液量情况及手术前、术后第1、2、3、7、14、30 d肌酐和尿素氮水平及患者转归情况。结果两组患者术中不同观察时间点MAP和CVP差异无统计学意义(P>0.05);两组患者术后30 d内肾功能指标、术中及术后1、2、3 d尿量、术后并发症、术后住院天数差异无统计学意义(P>0.05);传统补液组术中输液量及血管活性药物使用率较SVV组增多(P<0.05)。结论以CVP和尿量为目标导向的传统补液策略组围术期输液量较SVV目标导向组增多,但并不影响患者的近期肾功能和转归,传统补液策略可安全应用于亲属活体肾移植术。.
Objective To observe the effects of different target-directed fluid therapies such as central venous pressure(CVP),urinary volume,SVV and CO on the short-term renal function of living related kidney transplant recipients,and to explore the clinical significance of different target-directed fluid therapies in kidney transplantation. Methods One hundred patients,aged 18 ～ 55 years,weighing 50 ～ 80 kg,ASA Ⅲ or Ⅳ,scheduled for kidney transplantation,were randomly divided into CVP and urine volume target-guided group(n = 50)and SVV and CO target-guided group(n = 50). ECG,SpO_2,invasive arterial blood pressure and CVP were monitored during the operation in two groups.SVV and CO were monitored by FloTrac/Vigileo in the SVV-guided group.Hemodynamic parameters were recorded before anesthesia induction(T_0),30 minutes after operation(T_),5 minutes before renal artery opening(T_2),5 minutes after renal artery opening(T_3),0.5 hour after renal vascular opening(T_4),and the end of operation(T_5). And duration of operation,blood loss,infusion volume,urinary volume and vasoactive drugs used intraoperatively were monitored.The urine volume and infusion volume 1,2 and 3 days after the operation were recorded. Urea nitrogen(BUN)and creatinine(Cr)were recorded before the surgery and on day 1,2,7,14 and 30 after the surgery. Postoperative complication,renal allograft function and postoperative hospital stay in the two groups were also recorded. Results There was no significant difference in CVP and MAP between the two groups at different time points(P > 0.05). No significant difference was found in two groups of patients with renal allograft function within 30 days after the operation and urine volume of intraoperative,1,2 and 3 days after the operation(P > 0.05). There was also no significant difference in postoperative complications and hospitalization days between the two groups(P > 0.05). Intraoperative infusion volume and usage of vasoactive drugs in traditional fluid infusion group were higher than those in SVV target-guided group(P < 0.05). Conclusions Perioperative infusion volume of CVP and urine volume target-guided group is higher than that of SVV and CO targetguided group,but it exerts no effect on the short-term renal function and outcome of patients. Conventional fluid therapy can be safely applied to living-related renal transplantation..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019-08-14 11:18 2019 |
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| Erschienen: |
2019-08-14 11:18 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2019 |
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| Enthalten in: |
Shi yong yi xue za zhi - (2019), 15 vom: 14 11:18. Aug., Seite 2403-2406 Original Letters: Enthalten in 实用医学杂志 (DE-600)2989415-3 (DE-600)2989415-3 广东省广州市 |
| Reihe: |
China Academic Journals (CAJ), E, 医药卫生科技 = Medicine & Public Health |
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| Sprache: |
Chinesisch |
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| Weiterer Titel: |
Effect of different target-directed fluid therapy on recent renal function in living-related renal transplantation recipients |
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| Beteiligte Personen: |
潘坤云 [VerfasserIn] |
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| Links: |
oversea.cnki.net [lizenzpflichtig] |
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| Themen: |
中国科学技术大学附属第一医院(安徽省立医院)麻醉科 |
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| Anmerkungen: |
Author info:PAN Kunyun;XIE Yanhu;SHU Shuhua;WANG Di;CHAI Xiaoqing;Department of Anesthesiology,the First Affiliated Hospital of University of Science and Technology of China |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
CAJ637623177 |
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| 245 | 1 | 0 | |a 不同目标导向液体治疗对亲属活体肾移植受体术后近期肾功能的影响 |b = Effect of different target-directed fluid therapy on recent renal function in living-related renal transplantation recipients |
| 246 | 3 | 1 | |a Effect of different target-directed fluid therapy on recent renal function in living-related renal transplantation recipients |
| 264 | 1 | |c 2019-08-14 11:18 | |
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| 520 | |a 目的通过观察以中心静脉压(CVP)、尿量和每搏变异度(SVV)、心排量(CO)不同目标导向液体治策略对亲属活体肾移植受体术后近期肾功能的影响,探讨不同目标导向液体治疗在肾移植手术中的临床意义。方法选择择期亲属活体肾移植受体患者100例,年龄18～55岁,体质量50～80 kg,ASA分级Ⅲ～Ⅳ级,每组50例,随机分为以CVP和尿量为导向的传统补液组(C组)和以SVV、CO为导向的SVV组(SVV组)。两组患者常规行ECG、SpO_2、有创动脉血压、CVP监测。SVV组应用FloTrac/Vigileo监测SVV、CO等参数。记录麻醉诱导前(T_0),手术开始后30 min(T_1),肾动脉开放前5 min(T_2),肾动脉开放后5 min(T_3),肾动脉开放后30 min(T_4),手术结束时(T_5)血流动力学参数,手术时间、术中输液量、出血量、尿量,围术期血管活性药物使用比例及住院天数,记录术后1、2、3 d的尿量和输液量情况及手术前、术后第1、2、3、7、14、30 d肌酐和尿素氮水平及患者转归情况。结果两组患者术中不同观察时间点MAP和CVP差异无统计学意义(P>0.05);两组患者术后30 d内肾功能指标、术中及术后1、2、3 d尿量、术后并发症、术后住院天数差异无统计学意义(P>0.05);传统补液组术中输液量及血管活性药物使用率较SVV组增多(P<0.05)。结论以CVP和尿量为目标导向的传统补液策略组围术期输液量较SVV目标导向组增多,但并不影响患者的近期肾功能和转归,传统补液策略可安全应用于亲属活体肾移植术。 | ||
| 520 | |a Objective To observe the effects of different target-directed fluid therapies such as central venous pressure(CVP),urinary volume,SVV and CO on the short-term renal function of living related kidney transplant recipients,and to explore the clinical significance of different target-directed fluid therapies in kidney transplantation. Methods One hundred patients,aged 18 ～ 55 years,weighing 50 ～ 80 kg,ASA Ⅲ or Ⅳ,scheduled for kidney transplantation,were randomly divided into CVP and urine volume target-guided group(n = 50)and SVV and CO target-guided group(n = 50). ECG,SpO_2,invasive arterial blood pressure and CVP were monitored during the operation in two groups.SVV and CO were monitored by FloTrac/Vigileo in the SVV-guided group.Hemodynamic parameters were recorded before anesthesia induction(T_0),30 minutes after operation(T_),5 minutes before renal artery opening(T_2),5 minutes after renal artery opening(T_3),0.5 hour after renal vascular opening(T_4),and the end of operation(T_5). And duration of operation,blood loss,infusion volume,urinary volume and vasoactive drugs used intraoperatively were monitored.The urine volume and infusion volume 1,2 and 3 days after the operation were recorded. Urea nitrogen(BUN)and creatinine(Cr)were recorded before the surgery and on day 1,2,7,14 and 30 after the surgery. Postoperative complication,renal allograft function and postoperative hospital stay in the two groups were also recorded. Results There was no significant difference in CVP and MAP between the two groups at different time points(P > 0.05). No significant difference was found in two groups of patients with renal allograft function within 30 days after the operation and urine volume of intraoperative,1,2 and 3 days after the operation(P > 0.05). There was also no significant difference in postoperative complications and hospitalization days between the two groups(P > 0.05). Intraoperative infusion volume and usage of vasoactive drugs in traditional fluid infusion group were higher than those in SVV target-guided group(P < 0.05). Conclusions Perioperative infusion volume of CVP and urine volume target-guided group is higher than that of SVV and CO targetguided group,but it exerts no effect on the short-term renal function and outcome of patients. Conventional fluid therapy can be safely applied to living-related renal transplantation. | ||
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| 650 | 4 | |a 肾移植 | |
| 650 | 4 | |a 中心静脉压 | |
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