每搏量变异度指导围术期目标导向液体治疗的研究

发布时间：2018-06-18 03:03

  本文选题：每搏量变异度(SVV) + 液体治疗　； 参考：《新疆医科大学》2015年硕士论文

【摘要】：目的：针对每搏量变异度(Stroke Volume Variation,SVV)在围术期液体治疗当中的指导价值进行分析,为优化围术期目标导向液体治疗的最优方法提供更为准确有效的判定指标。方法：计算机检索Cochrane图书馆、Pubmed、EMbase、CINAHL、 Web of Science、中国生物医学文献数据库(CBM)、相关期刊论文(CNKI)等中外生物医学数据库,以stroke volume variation(SVV)、fluid therapy为检索词,搜索自2000年至今的所有相关参考文献,对相关资料文献进行阅读后,筛选并纳入液体反应性预测方面的动态容量性指标SW价值评价的随机对照实验,判断是否纳入meta分析的文献总量,按Cochrane系统评价方法,评价所纳入研究的文献质量,并提取有效数据后进行Meta分析,评价SW在指导围术期目标导向液体治疗准确性当中的价值。结果：纳入11篇文献当中的420例患者进行本次研究的meta分析,病例来源均为ICU与手术室,患者均经机械控制呼吸,潮气量在8-10ml/kg之间。对纳入文献与数据进行meta分析的结果显示,SVV基线值与液体反应性之间的相关性显著,相关系数值为0.718。SVV在液体反应性当中的预测指标敏感度为82.3%(95%CI为0.773-0.866),特异度为85%(95%CI为0.796-0.895),阳性似然比为5.245(95%CI为3.827-7.188),阴性似然比为0.21(95%CI为0.161-0.273),诊断比数比为26.291(95%CI为16.057-43.037)。SVV预测液体反应性的受试者工作特征曲线下面积AUC为0.9052。结果表明每搏量变异度(stroke volume variation.SVV)对围术期患者液体反应性能够准确预测,具有诊断性预测价值。结论：每搏量变异度(SVV)可以作为评价液体反应性的敏感指标,指导围术期液体治疗以达到液体治疗的最优化。
[Abstract]:Objective: to analyze the guiding value of Stroke Volume variation SVV in perioperative fluid therapy so as to provide a more accurate and effective index for optimizing the optimal method of perioperative goal-oriented fluid therapy. Methods: Chinese and foreign biomedical databases, such as the Cochrane Library Pubmedbase CINAHL, the Web of Science, the Chinese Biomedical Literature Database (CBMN) and the Chinese Journal Full-text Database (CNKI), were searched for all relevant references from 2000 to present. After reading the relevant literature, we selected and included the dynamic volume index SW value evaluation of liquid reactivity prediction in a randomized controlled trial to determine whether the total amount of literature included in the meta analysis was evaluated according to the Cochrane systematic evaluation method. To evaluate the quality of literature included in the study and to extract valid data and conduct meta-analysis to evaluate the value of SW in guiding the accuracy of target oriented fluid therapy during perioperative period. Results: meta analysis was performed in 420 patients who were included in 11 articles in this study. All the patients were from ICU and operating room. The patients were all breathed mechanically and the tidal volume was between 8-10ml/kg. The meta analysis of the literature and data showed a significant correlation between baseline values and liquid reactivity. The correlation coefficient value is 0.718.SVV, the predictive sensitivity in liquid reactivity is 82.33.95 and the CI is 0.773-0.866, the specificity is 850.796-0.895CI, the positive likelihood ratio is 5.24595 CI is 3.827-7.1888, the negative likelihood ratio is 0.2195CI 0.161-0.273C, the diagnostic ratio is 26.29195CI 16.057-43.037.SVV predicts the acceptance of fluid reactivity. The area under the work characteristic curve was 0.9052. The results showed that stroke volume variation.SVV could accurately predict the fluid reactivity of perioperative patients and had diagnostic predictive value. Conclusion: SVV can be used as a sensitive index to evaluate fluid reactivity and guide perioperative fluid therapy in order to optimize fluid therapy.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R614
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本文编号：2033741