目标导向液体治疗(goal-directed fluid therapy, GDFT)通常推荐用于接受大型手术的患者,并且是术后加速康复(enhanced recovery after surgery, ERAS)方案中必不可少的。这种液体治疗方案通常由动态血流动力学参数指导,旨在优化患者的...目标导向液体治疗(goal-directed fluid therapy, GDFT)通常推荐用于接受大型手术的患者,并且是术后加速康复(enhanced recovery after surgery, ERAS)方案中必不可少的。这种液体治疗方案通常由动态血流动力学参数指导,旨在优化患者的心输出量,以最大限度地向其重要器官输送氧气。虽然许多研究表明GDFT对围手术期患者有益并可减少术后并发症,但对于使用哪些动态血流动力学参数来指导GDFT尚无共识。此外,有许多血流动力学监测技术来测量这些动态血流动力学参数,每种技术都有其优缺点。本文将讨论和回顾常用的GDFT动态血流动力学参数和血流动力学监测技术。Goal-directed fluid therapy (GDFT) is generally recommended for patients undergoing major surgery and is essential in enhanced recovery after surgery ERAS regimens. This fluid regimen is often guided by dynamic hemodynamic parameters and is designed to optimize the patient’s cardiac output to maximize oxygen delivery to their vital organs. Although many studies have shown that GDFT is beneficial in perioperative patients and reduces postoperative complications, there is no consensus on which dynamic hemodynamic parameters should be used to guide GDFT. In addition, there are a number of hemodynamic monitoring techniques to measure these dynamic hemodynamic parameters, each with its advantages and disadvantages. This article will discuss and review commonly used dynamic hemodynamic parameters and hemodynamic monitoring techniques for GDFT.展开更多
术后睡眠障碍(postoperative sleep disturbances, PSD)是指术后患者在睡眠–觉醒过程中出现的一系列大脑功能性失调及自主性亢奋,表现为入睡困难、睡眠剥夺、睡眠数量和质量下降等。它可诱发术后疲劳、代谢紊乱、高血压和心脑血管疾病...术后睡眠障碍(postoperative sleep disturbances, PSD)是指术后患者在睡眠–觉醒过程中出现的一系列大脑功能性失调及自主性亢奋,表现为入睡困难、睡眠剥夺、睡眠数量和质量下降等。它可诱发术后疲劳、代谢紊乱、高血压和心脑血管疾病等,且被认为是术后谵妄(postoperative delirium, POD)发生的重要风险因素。本文旨在综述术后睡眠障碍的特征、风险因素以及预防和治疗策略,以期减少PSD的发生率,并提高围手术期患者的管理质量。Postoperative sleep disorder (postoperative sleep disturbances, PSD) refers to a series of brain dysfunction and autonomic hyperactivity in sleep-awakening, such as difficulty, sleep deprivation, sleep quantity and quality decline, etc. It can induce postoperative fatigue, metabolic disorders, hypertension and cardiovascular and cerebrovascular diseases, and is an important risk factor for the occurrence of postoperative delusion (postoperative delirium, POD). Here, we summarized the characteristics, risk factors, and prevention and treatment methods of postoperative sleep disorders, so as to reduce the occurrence of PSD and improve the quality of perioperative patient management.展开更多
文摘目标导向液体治疗(goal-directed fluid therapy, GDFT)通常推荐用于接受大型手术的患者,并且是术后加速康复(enhanced recovery after surgery, ERAS)方案中必不可少的。这种液体治疗方案通常由动态血流动力学参数指导,旨在优化患者的心输出量,以最大限度地向其重要器官输送氧气。虽然许多研究表明GDFT对围手术期患者有益并可减少术后并发症,但对于使用哪些动态血流动力学参数来指导GDFT尚无共识。此外,有许多血流动力学监测技术来测量这些动态血流动力学参数,每种技术都有其优缺点。本文将讨论和回顾常用的GDFT动态血流动力学参数和血流动力学监测技术。Goal-directed fluid therapy (GDFT) is generally recommended for patients undergoing major surgery and is essential in enhanced recovery after surgery ERAS regimens. This fluid regimen is often guided by dynamic hemodynamic parameters and is designed to optimize the patient’s cardiac output to maximize oxygen delivery to their vital organs. Although many studies have shown that GDFT is beneficial in perioperative patients and reduces postoperative complications, there is no consensus on which dynamic hemodynamic parameters should be used to guide GDFT. In addition, there are a number of hemodynamic monitoring techniques to measure these dynamic hemodynamic parameters, each with its advantages and disadvantages. This article will discuss and review commonly used dynamic hemodynamic parameters and hemodynamic monitoring techniques for GDFT.
文摘术后睡眠障碍(postoperative sleep disturbances, PSD)是指术后患者在睡眠–觉醒过程中出现的一系列大脑功能性失调及自主性亢奋,表现为入睡困难、睡眠剥夺、睡眠数量和质量下降等。它可诱发术后疲劳、代谢紊乱、高血压和心脑血管疾病等,且被认为是术后谵妄(postoperative delirium, POD)发生的重要风险因素。本文旨在综述术后睡眠障碍的特征、风险因素以及预防和治疗策略,以期减少PSD的发生率,并提高围手术期患者的管理质量。Postoperative sleep disorder (postoperative sleep disturbances, PSD) refers to a series of brain dysfunction and autonomic hyperactivity in sleep-awakening, such as difficulty, sleep deprivation, sleep quantity and quality decline, etc. It can induce postoperative fatigue, metabolic disorders, hypertension and cardiovascular and cerebrovascular diseases, and is an important risk factor for the occurrence of postoperative delusion (postoperative delirium, POD). Here, we summarized the characteristics, risk factors, and prevention and treatment methods of postoperative sleep disorders, so as to reduce the occurrence of PSD and improve the quality of perioperative patient management.
