本文選題：每搏量變異度(SVV) + 液體治療��； 參考：《新疆醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的：針對每搏量變異度(Stroke Volume Variation,SVV)在圍術(shù)期液體治療當(dāng)中的指導(dǎo)價值進(jìn)行分析,為優(yōu)化圍術(shù)期目標(biāo)導(dǎo)向液體治療的最優(yōu)方法提供更為準(zhǔn)確有效的判定指標(biāo)。方法：計算機(jī)檢索Cochrane圖書館、Pubmed、EMbase、CINAHL、 Web of Science、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(CBM)、相關(guān)期刊論文(CNKI)等中外生物醫(yī)學(xué)數(shù)據(jù)庫,以stroke volume variation(SVV)、fluid therapy為檢索詞,搜索自2000年至今的所有相關(guān)參考文獻(xiàn),對相關(guān)資料文獻(xiàn)進(jìn)行閱讀后,篩選并納入液體反應(yīng)性預(yù)測方面的動態(tài)容量性指標(biāo)SW價值評價的隨機(jī)對照實驗,判斷是否納入meta分析的文獻(xiàn)總量,按Cochrane系統(tǒng)評價方法,評價所納入研究的文獻(xiàn)質(zhì)量,并提取有效數(shù)據(jù)后進(jìn)行Meta分析,評價SW在指導(dǎo)圍術(shù)期目標(biāo)導(dǎo)向液體治療準(zhǔn)確性當(dāng)中的價值。結(jié)果：納入11篇文獻(xiàn)當(dāng)中的420例患者進(jìn)行本次研究的meta分析,病例來源均為ICU與手術(shù)室,患者均經(jīng)機(jī)械控制呼吸,潮氣量在8-10ml/kg之間。對納入文獻(xiàn)與數(shù)據(jù)進(jìn)行meta分析的結(jié)果顯示,SVV基線值與液體反應(yīng)性之間的相關(guān)性顯著,相關(guān)系數(shù)值為0.718。SVV在液體反應(yīng)性當(dāng)中的預(yù)測指標(biāo)敏感度為82.3%(95%CI為0.773-0.866),特異度為85%(95%CI為0.796-0.895),陽性似然比為5.245(95%CI為3.827-7.188),陰性似然比為0.21(95%CI為0.161-0.273),診斷比數(shù)比為26.291(95%CI為16.057-43.037)。SVV預(yù)測液體反應(yīng)性的受試者工作特征曲線下面積AUC為0.9052。結(jié)果表明每搏量變異度(stroke volume variation.SVV)對圍術(shù)期患者液體反應(yīng)性能夠準(zhǔn)確預(yù)測,具有診斷性預(yù)測價值。結(jié)論：每搏量變異度(SVV)可以作為評價液體反應(yīng)性的敏感指標(biāo),指導(dǎo)圍術(shù)期液體治療以達(dá)到液體治療的最優(yōu)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.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R614
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本文編號：2033741