| 摘要: |
| 摘 要：目的 探讨目标导向液体治疗（GDFT）在胸腔镜肺癌根治术中的应用价值。方法 94 例行胸腔镜肺癌根
治术患者随机分为观察组和对照组。观察组采用GDFT，对照组采用常规液体治疗。比较两组患者围术期的血流动力学
指标、术中肺通气功能指标、手术观察指标和认知功能。结果 在单肺通气 1 h和术毕即刻，观察组的平均动脉压（MAP）、
中心静脉压（CVP）、呼吸指数（RI）均明显低于对照组，而脑氧饱和度（rSO 2 ）和氧合指数（OI）均明显高于对照组（P<0.05
或 0.01）。观察组胶体补液量、晶体补液量、尿量、补液总量均明显少于对照组，使用血管活性药物构成比低于对照组
（P<0.05 或 0.01）。术后 1 d时，观察组的智力状态检查量表（MMSE）评分明显高于对照组，认知功能障碍发生率低于对
照组（P<0.05）。结论 在胸腔镜肺癌根治术中采用GDFT能够稳定血流动力学，控制容量负荷，减少血管活性药物的使
用率，减轻肺通气功能损伤和降低认知功能障碍发生率。 |
| 关键词: 胸腔镜肺癌根治术 目标导向液体治疗 |
| DOI： |
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| 基金项目:广东省医学科学技术研究基金项目（C2022130），湛江市科技发展专项资金竞争性分配项目（2022A01200） |
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| Application of goal-directed fluid therapy in the thoracoscopic radical resection of lung cancer |
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| Abstract: |
| Abstract: Objective To investigate the application value of goal-directed fluid therapy (GDFT) in the thoracoscopic
radical resection of lung cancer. Methods A total of 94 patients who have received thoracoscopic radical resection of lung
cancer were randomly divided into the Observation Group and the Control Group. The Observation Group received GDFT,
while the Control Group received conventional fluid therapy. The hemodynamic indicators, intraoperative pulmonary ventilation
function indicators, surgical observation indicators, and cognitive functions between the two groups were compared. Results
At 1 h of single lung ventilation and immediately after operation, the MAP, CVP, and RI of the Observation Group were
significantly lower than those of the Control Group, while rSO 2 and OI of the Observation Group were significantly higher than
those of the Control Group (P<0.05 or 0.01); the colloid rehydration, crystal rehydration, urine volume, and total rehydration of
the Observation Group were significantly less than those of the Control Group, and the proportion of patients using vasoactive
drugs in the Observation Group was significantly lower than that of the Control Group (P<0.05 or 0.01). At 1 d after operation,
the MMSE score of the Observation Group was significantly higher than that of the Control Group, and the incidence of
cognitive impairment of the Observation Group was significantly lower than that of the Control Group (P<0.05). Conclusion
GDFT can stabilize hemodynamics, control volume load, reduce the use rate of vasoactive drugs, reduce the damage of lung
ventilation function and decrease the incidence of cognitive dysfunction during thoracoscopic radical resection of lung cancer. |
| Key words: thoracoscopic radical resection of lung cancer goal-directed fluid therapy |