USCOM在髋关节置换术病人容量治疗中的应用及对早期预后的影响

    The application value of USCOM in volume therapy of patients treated with hip replacement and its effect on early prognosis

    • 摘要:
      目的探析超声心输出量监测仪(USCOM)在髋关节置换手术病人容量治疗中的临床应用价值及其对病人早期预后的影响。
      方法将接受容量治疗的126例髋关节置换术病人随机分成观察组(USCOM监测补液)和对照组(常规补液),各63例。比较2组病人的基线资料、临床指标、不同时点动脉血乳酸水平及术后并发症发生情况。
      结果2组病人年龄、性别、体质量指数、手术时间、麻醉时间、ASA分级、合并症等基线资料比较差异无统计学意义(P>0.05)。观察组病人的术中出血量、尿量、晶体液用量、总输液量及总住院时间均明显低于对照组,且胶体液用量明显高于对照组(P < 0.01);2组病人的血管活性药物使用情况差异无统计学意义(P>0.05)。T1时刻观察组病人的动脉血乳酸水平明显低于对照组(P < 0.01);其他时刻2组病人的动脉血乳酸水平差异均无统计学意义(P>0.05)。观察组病人术后恶心呕吐、贫血并发症发生率明显低于对照组(P < 0.01)。
      结论USCOM在髋关节置换手术病人容量治疗中具有突出的临床疗效,可减少术后并发症发生,改善病人早期预后。

       

      Abstract:
      ObjectiveTo investigate the clinical application value of ultrasonic cardiac output monitor(USCOM) in volume therapy of patients treated with hip replacement and its effect on early prognosis.
      MethodsOne hundred and twenty-six volume therapy patients treated with hip replacement were randomly divided into the observation group(USCOM monitoring fluid replacement, 63 cases) and control group(routine fluid replacement, 63 cases).The general information, clinical indicators, arterial blood lactic acid levels at different time points and occurrence of postoperative complications between two groups were compared.
      ResultsThe differences of the baseline data of age, sex, body mass index, operation time, anesthesia time, ASA grade and complications between two groups were not statistically significant(P>0.05).The intraoperative bleeding volume, urine volume, total crystalloid volume, total transfusion volume and total hospitalization time in observation group were obviously lower than those in control group, and the colloid liquid volume in observation group was obviously higher than that in control group(P < 0.01).The differences of the vasoactive drugs usage between two groups was not statistically significant(P>0.05).The arterial blood lactate level in observation group was obviously lower than that in control group at T1(P < 0.01), and the differences of the arterial blood lactate levels at other time-points between two groups were not statistically significant(P>0.05).The incidence rates of nausea, vomiting and nemia of postoperative complications in observation group were obviously lower than those in control group(P < 0.01).
      ConclusionsThe clinical effects of USCOM in volume therapy of patients treated with hip replacement is significant, which can reduce the occurrence of postoperative complications and improve the early prognosis of patients.

       

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