CAJ | 학술논문

背景现代麻醉在保障手术患者术中良好的镇静、镇痛、肌松、抑制应激反应的同时,更多关注患者围手术期多脏器功能的保护.特别在处理有明显的病理生理异常的患者时,麻醉医生需要监测更多心血管系统参数,使用液体和血管活性药使心脏前负荷、后负荷、血管张力达到最优水平,满足重要脏器的灌注. 目的主要介绍目标指导液体治疗(goal-directed therapy,GDT)在高危手术患者的应用. 内容 GDT是指通过使用液体和血管活性药使心脏前负荷、后负荷、血管张力达到最优水平,时时保证冠状动脉灌注压.介绍GDT的研究背景、依据及如何在高危患者手术应用. 趋向 GDT为临床医生处理危重症患者提供了更有效、更标准的方法,它的应用前景更加光明.
배경 현대마취재보장수술환자술중량호적진정、진통、기송、억제응격반응적동시,경다관주환자위수술기다장기공능적보호.특별재처리유명현적병리생리이상적환자시,마취의생수요감측경다심혈관계통삼수,사용액체화혈관활성약사심장전부하、후부하、혈관장력체도최우수평,만족중요장기적관주. 목적 주요개소목표지도액체치료(goal-directed therapy,GDT)재고위수술환자적응용. 내용 GDT시지통과사용액체화혈관활성약사심장전부하、후부하、혈관장력체도최우수평,시시보증관상동맥관주압.개소GDT적연구배경、의거급여하재고위환자수술응용. 추향 GDT위림상의생처리위중증환자제공료경유효、경표준적방법,타적응용전경경가광명.
Background Modem anesthesia is not only to keep the surgical patients sedative,analgesic,muscle relaxed,less stress reactive,but also to pay more attention to protecting the organ function during the operation.The anesthetists need to monitor more parameters of cardiovascular system,especially when they treat the patients with severe organ dysfunction,in order to optimize the preload,contractility and afterload of the heart whilst to maintain an adequate main organs' perfusion.Objective The article reviews the applications of goal-directed therapy (GDT) in patients undergoing high risk surgery.Content The GDT is to optimize the preload,contractility and afterload of the heart whilst maintain an adequate coronary perfusion pressure with the uses of fluid loading and inotropes infusion.The background,evidence,and how to perform GDT in high risk surgical patients are introduced.Trend GDT provides a more effective and more accurate assessment mothod for clinical practice,which has a bright application prospect.