摘要
目的系统评价控制性低中心静脉压(CLCVP)与每搏量变异度(SVV)指导的目标导向液体治疗用于肝脏手术的有效性和安全性。方法计算机检索PubMed、Web of Science、Cochrane Library、Embase、中国知网、万方数据和中国生物医学文献数据库,纳入关于CLCVP和SVV指导的目标导向液体治疗用于肝脏手术的比较的随机对照试验(RCTs),检索时间为数据库建库至2023年4月,采用RevMan 5.4软件对纳入文献进行统计分析。结果共纳入16篇RCTs,患者987例,其中CLCVP组494例,SVV组493例。Meta分析结果显示,与CLCVP组比较,SVV组术中出血量明显减少(MD=-27.13 ml,95%CI-30.79~-23.47 ml,P<0.05)、术后并发症发生率明显降低(OR=0.37,95%CI 0.24~0.56,P<0.05)、住院时间明显缩短(MD=-2.82 d,95%CI-3.39~-2.24 d,P<0.05)。结论SVV指导的目标导向液体治疗用于肝脏切除可以优化术中液体管理,减少术中出血量,降低术后并发症发生率。
Objective To systematically evaluate the efficacy and safety of goal-directed fluid therapy guided by controlled low central venous pressure(CLCVP)versus stroke volume variability(SVV)for liver surgery.Methods PubMed,Web of Science,Cochrane Library,Embase,CNKI,Wanfang Data and China Biomedical Literature Database were searched by computer to collect randomized controlled trials(RCTs)on the comparison of goal-directed fluid therapy guided by CLCVP and SVV in liver surgery.The retrieval period was from the establishment of the database to April 2023.Meta-analysis of the included literature was performed using RevMan 5.4 software.Results Sixteen RCTs were included,a total of 987 patients were included,including 494 patients in the CLCVP group and 493 patients in the SVV group.Meta-analysis results showed that,compared with the CLCVP group,the intraoperative bleeding were significantly reduced in the SVV group(MD=-27.13 ml,95%CI-30.79 to-23.47 ml,P<0.05),postoperative complication rates were significantly reduced(OR=0.37,95%CI 0.24 to 0.56,P<0.05),and length of hospitalization were significantly shorten(MD=-2.82 days,95%CI-3.39 to-2.24 days,P<0.05).Conclusion In liver resection,SVV-guided goal-directed fluid therapy can optimize intraoperative fluid management,reduce intraoperative blood loss,and reduce the incidence of postoperative complications.
作者
董育硕
高巨
陈宁翊
张婷婷
李琳
葛亚丽
DONG Yushuo;GAO Ju;CHENG Ningyi;ZHANG Tingting;LI Lin;GE Yali(Department of Anesthesiology,Northern Jiangsu People's Hospital Affiliated to Yangzhou University Clinical Medical College,Yangzhou 225001,China)
出处
《临床麻醉学杂志》
北大核心
2025年第2期176-182,共7页
Journal of Clinical Anesthesiology
基金
江苏省青年医学重点人才项目(QNRC2016337)。
