胸科手术的血流动力学监测与液体管理研究进展

Research progress of hemodynamic monitoring and fluid management in thoracic surgery

围术期液体治疗作为麻醉管理的重要组成部分,其主要目的是维持器官和组织灌注,保证组织氧供需平衡,保护脏器功能,促进患者快速康复。胸科手术围术期液体输注不足或过负荷均可影响患者预后,使用合适的监测方法准确监测血流动力学指标是液体管理的基础。目标导向液体治疗(GDFT)是以血流动力学为目标,通过液体负荷,维持围术期每搏量最大化,对加速患者康复、减少住院时间有重要的作用,目前已广泛用于临床。本文将从胸科疾病的围术期液体管理特点、GDFT的血流动力学监测指标和监测方法等方面进行综述,以期为临床工作提供指导。

Perioperative fluid therapy is an important part of anesthesia management. Its main purpose is to maintain the perfusion of organs and tissues, ensure the balance of oxygen supply and demand, protect the function of organs and promote the rapid recovery of patients. Underload or overload of perioperative fluid infusion can affect the prognosis of patients during thoracic surgery .It is the basis of fluid management to using appropriate methods to accurately monitor of hemodynamic parameters. Goal-directed fluid therapy (GDFT), with hemodynamic parameters as targets, maximizes perioperative stroke volume through fluid loading. It plays an important role in accelerating patient recovery and reducing hospital stay and has been widely used in clinical. This article will review the progress of perioperative fluid management characteristics and circulatory function monitoring methods in thoracic surgery in order to provide guidance for clinical work.