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| 每搏量变异度指导的目标导向液体治疗用于肝脏手术有效性和安全性的Meta分析 |
| Efficacy and safety of stroke volume variability-guided goal-directed fluid therapy in hepatectomy: a meta-analysis |
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| DOI：10.12089/jca.2025.02.013 |
| 中文关键词: 肝脏切除术 每搏量变异度 目标导向液体治疗 Meta分析 |
| 英文关键词: Liver resection Stroke volume variability Goal-directed fluid therapy Meta-analysis |
| 基金项目:江苏省青年医学重点人才项目（QNRC2016337） |
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| 中文摘要: |
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。 |
| 英文摘要: |
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 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. |
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