关键词: 目标导向输液, 肺部超声, 腰椎手术, 老年病人

Abstract: Objective To evaluate the effect of target oriented infusion guided by stroke volume variation (SVV) in elderly lumbar surgery.Method  From January to December 2023, 80 elderly patients undergoing elective general anesthesia for prone lumbar surgery were divided into two groups by random number table method: SVV guidance target-oriented infusion group (SVV group) and conventional infusion group (conventional group), with 40 cases in each group.The amount of infusion, blood loss, urine volume and use of vasoactive drugs in the two groups were recorded. MAP, HR, blood lactate concentration (Lac), base residual value (BE), and PaO-2 were recorded at the time of entry (T₁), before cuticle (T₂), 1- hour after prone position (T₃), and after surgery (T₄).Pulmonary ultrasound examinations were performed at 4, 8, 12 and 24 hours after surgery, and Bline scores were calculated, as well as the incidence of cardiac insufficiency, nausea, vomiting, delirium and hospital stay at 24 hours after surgery.Result Compared with normal group, in group SVV, intraoperative infusion volume [(1123 + 532)ml], vascular active drug utilization rate (15.0%), postoperative each point B line score [(1.55±1.32), (1.22±0.94), (1.01±0.93), (1.07±0.90)] were reduced (P<0.05).HR at T₂～T₄ [(67±8,71±11,73±12) times/min]、PaO₂ at T₃,T₄ [(438±41,423±44) mmHg] were increased,Lac and BE at T₂～T₄ were (0.3±0.5,1.4±0.5,1.4± 0.3) mmol/L.(0.3±0.6,0.3±1.0,0.3± 1.1)was decreased (P<0.05).There were no significant differences between the two groups in cardiac dysfunction,nausea,vomiting,delirium and hospital stay after a 24-hour postoperative period (P>0.05).Conclusion SVV guided target oriented infusion in elderly lumbar surgery is beneficial to circulation stability and tissue perfusion, and reduces the production of lung water.

Key words: guided liquid therapy, lung ultrasound, lumbar surgery, elderly patients