%A ZHANG Yafei, WU Chao, XIAO Jifeng. %T The effect of goal-directed fluid therapy on postoperative cognitive dysfunction in elderly patients undergoing colorectal carcinoma radical surgery %0 Journal Article %D 2020 %J JOURNAL OF CLINICAL SURGERY %R 10.3969/j.issn.1005-6483.2020.04.022 %P 370-373 %V 28 %N 4 %U {http://www.lcwkzz.com/CN/abstract/article_4141.shtml} %8 2020-04-20 %X Objective To evaluate the effect of goal-directed fluid therapy on postoperative cognitive dysfunction in elderly patients undergoing colorectal carcinoma radical surgery. Methods 98 patients undergoing colorectal carcinoma radical surgery,were randomly divided into goal-directed fluid therapy group(GDFT group)and control group(Con group)by random sequences generated by SPSS 17.0,49 cases in each group.The radial artery puncture catheter was connected to the Vigileo-FloTrac system for monitoring stroke volume variation(SVV).Fluid infusion was guided by goal-directed fluid therapy based on SVV in GDFT group.Conventional therapy was used in Con group.The MMSE score was assessed at 1 day before surgery,1 day,3 days,1 week,1 month,3 months and 6 months after surgery,and the postoperative cognitive dysfunction was diagnosed with 1SD principle.Peripheral venous blood was extracted at 1 day before surgery,1 day,3 days and 1 week after surgery for the detection of S100 immunoglobulin and neuron-specific enolase(NSE). Results The incidence of POCD in the GDFT group at 1 day after surgery(30.6%/57.1%),3 days after surgery(28.6%/55.1%),1 week after surgery(22.4%/51.0%),1 month after surgery(16.7%/42.6%),3 months after surgery(17.4%/39.1%)〖JP3〗and 6 months after surgery(15.6%/36.4%) was significantly lower than that in the Con group,with statistically significant differences(P<0.05).There was no statistically significant difference in S100 serum protein [(121.4±13.4)pg/ml and(122.3±11.6)pg/ml] and NSE [(6.8±1.1)ng/ml and(7.0±1.2)ng/ml] concentrations between the two groups at 1 day before surgery(P>0.05).The concentration of S100 [(206.6±18.7)pg/ml and(231.5±17.3)pg/ml],[(191.8±14.6)pg/ml and(217.9±15.8)pg/ml],[(171.5±13.3)pg/ml and(195.7±16.2)pg/ml] and NSE [(19.4±1.6)ng/ml and(24.7±2.1)ng/ml],[(17.3±1.8)ng/ml and(22.0±2.3)ng/ml],[(15.9±1.8)ng/ml and(20.6±2.0)ng/ml] in the GDFT group at 1 day after surgery,3 days after surgery and 1 week after surgery was significantly lower than that in the Con group(P<0.05). Conclusion Goal-directed fluid therapy can reduce the incidence of POCD in elderly patients undergoing colorectal carcinoma radical surgery within 6 months after surgery.