国际麻醉学与复苏杂志   2019, Issue (8): 0-0
    
容量反应性评估的新认识
王骁颖, 高巨1()
1.江苏省苏北人民医院
The new recognition of fluid responsiveness assessment
 全文:
摘要:

容量反应性的评估方法在临床上除了传统的补液负荷(volume expansion, VE)和被动抬腿实验(passive leg raising test, PLR)外,术中引起血流动力学波动的过程(如气腹放气、按压肝脏、肺复张等)也可以评估容量反应性。容量反应性的监测指标除传统静态压力性指标外,近几年来超声评估容量反应性在ICU和围手术期逐渐受到关注。文章对容量反应性的评估方法、监测指标、评估阈值的最新研究进展进行综述,并在研究证据的基础上提出围手术期液体治疗的具体建议。在实际工作中需要综合各个类型指标和评估方法,部分判别指标和评估方法还需临床医师进一步验证。

关键词: 容量反应性; 监测指标; 补液
Abstract:

Clinically, apart from traditional assessment method such as volume expansion (VE) and passive leg experiment (PLR), the procedure that may cause hemodynamic fluctuation during surgery can also assess fluid responsiveness, such as desufflation in laparoscopic surgery, liver compression, and lung recruitment. Besides static pressure indices, increasing attention has been drawn on fluid responsiveness assessed by ultrasound in intensive care unit (ICU) or perioperative in recent years. This article reviewed the latest progress in fluid responsiveness assessment, especially assessment method, monitor indices and cut-off value, and proposed specific recommendations for perioperative fluid therapy. It′s wise for physicians to synthesize different indices and methods when give a assessment of fluid therapy, and part of which need more researches to verify.

Key words: Fluid responsiveness; Monitor indices; Volume expansion