CAJ | 학술논문

目的探讨目标导向液体治疗对老年膀胱癌根治术患者术中凝血状态的影响.方法选取本院2012年10月至2014年10月老年膀胱癌根治术患者122例 ,采用随机数字表法分为2组 ,61例患者实施常规治疗为对照组 ,61例患者实施目标导向液体治疗为观察组 ,比较2组患者术中凝血指标[全血活化凝固时间(ACT )、凝结速率(CR)、血小板功能(PF)、D-二聚体]及相关指标[每搏变异度(SVV )、中心静脉血氧饱和度(ScvO2 )、心排血指数(CI)]的改变情况.结果 2组患者T1时ACT、CR、PF、D-二聚体、ScvO2 均显著增加 ,SVV、CI均显著降低 ,直到手术结束.观察组患者T1 、T2 、T3 、T4 时ACT、CR、PF、D-二聚体均明显低于对照组 ,SVV、ScvO2 、CI均明显高于对照组 ,差异均有统计学意义(P<0 .05).结论目标导向液体治疗有助于维持老年膀胱癌根治术患者术中凝血指标稳定 ,能提高ScvO2 ,并降低SVV和CI ,值得临床推广使用.
목적 탐토목표도향액체치료대노년방광암근치술환자술중응혈상태적영향.방법 선취본원2012년10월지2014년10월노년방광암근치술환자122례 ,채용수궤수자표법분위2조 ,61례환자실시상규치료위대조조 ,61례환자실시목표도향액체치료위관찰조 ,비교2조환자술중응혈지표[전혈활화응고시간(ACT )、응결속솔(CR)、혈소판공능(PF)、D-이취체]급상관지표[매박변이도(SVV )、중심정맥혈양포화도(ScvO2 )、심배혈지수(CI)]적개변정황.결과 2조환자T1시ACT、CR、PF、D-이취체、ScvO2 균현저증가 ,SVV、CI균현저강저 ,직도수술결속.관찰조환자T1 、T2 、T3 、T4 시ACT、CR、PF、D-이취체균명현저우대조조 ,SVV、ScvO2 、CI균명현고우대조조 ,차이균유통계학의의(P<0 .05).결론 목표도향액체치료유조우유지노년방광암근치술환자술중응혈지표은정 ,능제고ScvO2 ,병강저SVV화CI ,치득림상추엄사용.
Objective To investigate influence of goal-directed fluid therapy on intraoperative coagulation state in elderly patients with radical resection of bladder cancer .Methods One hundred and twenty-two elderly patients with radical resection of bladder cancer were selected in hospital from October 2012 to October 2014 ,who were randomly divided into two groups .Sixty one patients received routine treatment as control group .Sixty one patients received goal-directed fluid therapy as observation group .Changes of intraoperative blood coagulation in-dexes(ACT ,CR ,PF ,D-dimer) and related indexes (SVV ,ScvO2 ,CI) were compared between two groups .Re-sults CT ,CR ,PF ,D-dimer and ScvO2 significantly increased at T1 while SVV and CI significantly decreased in two groups until the end of surgery .ACT ,CR ,PF and D-dimer at T1 ,T2 ,T3 ,T4 in observation group were sig-nificantly lower than those in control group .SVV ,ScvO2 and CI in observation group were significantly higher than those in the control group .Differences were statistically significant (P<0 .05) .Conclusion Goal-directed fluid therapy is helpful to maintain intraoperative coagulation indexes stability in elderly patients with radical resec-tion of bladder cancer ,which can improve ScvO2 and reduce SVV ,CI .It is worthy of clinical use .