目标导向液体治疗(goal directed fluid therapy, GDFT)作为一种优化的围手术期液体治疗管理方案,能够改善围手术期凝血功能,但其机制尚未完全明确。文章综述了常规液体治疗时液体类型、血液稀释和多糖包被(endothelial glycocalyx, EG)损伤导致凝血功能紊乱,以及GDFT通过减少术中出血和EG脱落等改善围手术期患者凝血功能的研究进展,为临床医师在围手术期容量管理中选择合理的液体治疗方案提供参考,减少术后并发症,加速患者康复。
Goal directed fluid therapy (GDFT) is an optimized perioperative fluid therapy management plan. It has been found that GDFT can improve coagulation function, but the mechanism of regulation of the coagulation function is not completely clear. This review summarizes the research advances on types of fluid, blood dilution, and endothelial glycocalyx (EG) damage in traditional fluid therapy that causes coagulation dysfunction. In addition, research advances on GDFT improving coagulation function by reducing intraoperative bleeding and avoiding EG degradation are also summarized. This review allows clinicians to choose a relatively reasonable fluid therapy plan in perioperative volume management, aims to reduce postoperative complications, and accelerate patient recovery.
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