目标导向液体治疗对小儿癫痫病灶切除术术后转归的影响

Effects of goal-directed fluid therapy on postoperative outcomes in children epilepsy surgery

目的探讨术中脉压变异度指导的目标导向液体治疗对小儿癫痫病灶切除术术后转归的影响。方法回顾性分析38例行癫痫病灶切除术患儿的临床资料。根据术中是否应用以脉压变异度为指导的目标指导液体治疗分为目标导向液体组(G组)及传统输液组(C组)。比较2组患儿术中液体使用量、术后并发症发生率以及住院天数等方面的差异。结果 G组24例(63.2%),C组14例(36.8%)。2组手术时间、切除3个及以上脑叶的比例、术中出血量及胶体液输注量等差异均无统计学意义(P>0.05)。2组患儿晶体液输注量的差异有统计学意义[(1 904±689)mlvs.(1 353±878)ml,P=0.039]。2组患儿住院时间以及术后各系统并发症发生率的差异无统计学意义(P>0.05)。结论术中采用脉压变异度指导的目标导向液体治疗可能对小儿癫痫病灶切除术术后并发症发生率及术后转归无明显影响。

Objective To investigate the influence of goal-directed fluid therapy （GDFT） by pulse pressure variation （PPV） on postoperative outcomes in children undergoing epilepsy surgery. Methods This retrospective single-center study included 38 children undergoing epilepsy surgery, who were divided into the GDFT group （G group） and conventional fluid management group （C group）. The amount of fluid infused, postoperative complications and duration of hospitalization were compared between the two groups. Results 63.2% （24/38） children were divided into G group during operation. There was no difference between the two groups in operation time, proportion of t〉3 lobes resection, amount of bleeding and colloidal solution （P 〉 0.05）. Intra-operative crystalloid fluid volume infused during the operation was significantly higher in G group compared with C group [（1 904±689）ml vs. （1 353±878）ml, P = 0.039]. There was no significant difference between the two groups in duration of hospitalization and postoperative complications （P 〉 0.05）. Conclusion GDFT might not be effective to reduce postoperative complications and improve the outcomes during children epilepsy surgery.