目标导向液体治疗对颅内肿瘤切除术患者术中局部脑氧饱和度的影响

Effects of goal-direct therapy on intraoperative regional cerebral oxygen saturation in patients with intracranial tumor resection

目的：观察目标导向液体治疗（GDT）对颅内胶质瘤切除术患者术中局部脑氧饱和度（rSO2）的影响。方法60例ASAⅡ～Ⅲ级胶质瘤患者随机分为两组，试验组（G组），行GDT；对照组（C组），行常规输液治疗。连续监测心电图（ECG）、平均动脉压（MAP）、中心静脉压（CVP）、心输出量（CO），比较术前30 min（T0）、麻醉诱导后15 min（T1）、术中1 h（T2）、2 h（T3）、3 h （T4），及术毕（T5）的心指数（CI）、rSO2。结果与T0时比较，两组T1～T5时点rSO2均降低，差异有统计学意义（P＜0．05）；G组T2～T5时点rSO2、MAP、CVP与CI值均高于C组，差异有统计学意义（P＜0．05）。G组T2～T5时的MAP、CVP与CI值均高于C组，差异有统计学意义（P＜0．05）。结论 GDT应用于颅内胶质瘤切除术，可以提升术中rSO2。

Objective To observe the effects of goal-direct therapy （GDT）on intraoperative regional cerebral oxygen saturation （rSO2 ）in patients with intracranial tumor resection.Methods Sixty ASAⅡ-Ⅲ adult patients undergoing elective glioma resection were randomly divided into two groups with 30 cases in each：the Group G （goal-direct therapy）and the Group C （conventional infusion）.ECG, BP,central venous pressure（CVP）and cardiac output （CO）were continuously monitored.Cardiac index（CI）and rSO2 were recorded at dif-ferent time of 30 min before operation （T0）,at 15 min after anesthesia induction（T1）,1 h（T2）,2 h（T3）and 3 h（T4）after the operation beginning and the end of operation（T5）.Results Compared with T0,the rSO2 at T1 -T5 was decreased in both groups （P〈0.05）,and the rSO2 MAP,CVP and CI index at T2-T5 were higher in Group G than those in Group C （P〈0.05）.Conclusion The intraoperative rSO2 can be improved by moderate degree of GDT in patients undergoing glioma resection.