目的：探讨超声在老年患者目标靶向液体管理中的应用效果。方法选取华北理工大学附属医院2012年10月至2014年10月老年全身麻醉手术患者232例，采用随机数字表法分为2组，对照组116例实施中心静脉压指导目标靶向液体管理，观察组116例实施超声指导目标靶向液体管理，比较2组应用的效果。结果观察组在 T1、T2、T3、T4时心输出指数、每搏变异度、平均动脉压、中心静脉压、中心静脉血氧饱和度、氧供指数、氧耗指数、氧摄取率高于对照组（P ＜0.05）。观察组在 T1、T2、T3、T4时动脉血清乳酸低于对照组（P ＜0.05）。观察组尿量、胶体液量多于对照组（P ＜0.05）。观察组晶体液量、总输入量少于对照组（P ＜0.05）。观察组并发症发生率低于对照组（P ＜0.05）。结论在目标靶向液体管理中，超声指导有助于稳定老年患者的血流动力学指标和代谢指标，可有效维持机体氧供需平衡，能保证微循环灌注，具有较高的安全性。%Objective To investigate application effect of ultrasound in goal-directed fluid management of elderly patients.Methods Two hundred and thirty-two elderly patients with general anesthesia operation were se-lected in affiliated hospital of North China University of Science and Technology from October 2012 to October 2014,who were divided into two groups by random number table method.One hundred and sixteen patients under-went central venous pressure guidance in goal-directed fluid management were treated as control group.One hun-dred and sixteen patients underwent ultrasound guidance in goal-directed fluid management were treated as obser-vation group.Application effect was compared between two groups.Results Cardiac index(CI),stroke volume variation(SVV),mean arterial pressure(MAP),central venous pressure(CVP),central venous oxygen saturation (ScvO2 ),oxygen supply index(DO2 I),oxygen consumption index(VO2 I),and oxygen uptake rate(ERO2 )in ob-servation group were higher than those in control group at T1 ,T2 ,T3 ,T4 (P <0.05).Lactate(Lac)in observa-tion group were lower than that in control group at T1 ,T2 ,T3 ,T4 (P <0.05).Urine volume and colloid fluid volume in observation group were more than those in control group (P <0.05).Crystal liquid volume,total input in observation group were less than those in control group (P <0.05).Complication rate in observation group was lower than that in control group (P < 0.05).Conclusion In goal-directed fluid management,ultrasound guidance is beneficial for stabilization of hemodynamic and metabolic markers in elderly patients,which can effec-tively maintain oxygen balance of supply and demand.Ultrasound guidance can guarantee microcirculation perfu-sion,which has high safety.
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