Abstract: Objective To investigate the effect of goal?directed fluid therapy（GDFT）in cytoreductive surgery（CRS）combined hyperthermic intraperitoneal chemotherapy（HIPEC）. Methods This was a prospective approach. Eighty?six peritoneal metastases patients receiving CRS combined HIPEC were assigned to the control group and GDFT group （43 cases each group）. In the perioperative period ， patients in the control group received classical fluid therapy and patients in GDFT group received GDFT. Patients′ general information，hemodynamic index during surgery，lactic acid at the end of surgery， length of hospitalization，urine volume，intraoperative volume replacement，intraoperative bleeding volume ， usage of furosemide and dopamine，postoperative complications，intensive care unit（ICU）readmission and perioperative mortality were recorded. Results There were no significant differences in patients′ general information between two groups （P>0.05）. Crystalloid volume replacement and total volume replacement were significantly lower and colloid volume replacement was significantly higher in the experimental group than that in the control group （P<0.05）. Mean arterial pressure 30 min after surgery was significantly lower in the experimental group than that in the control group（P<0.05）. The ratio of usage of furosemide and dopamine，lactic acid at the end of surgery，length of hospitalization，ratio of postoperative abdominal，cardiac，respiratory and hepatic complication and ICU readmission were significantly lower in the experimental group than that in the control group （P<0.05）. Conclusion GDFT could decrease intraoperative volume replacement，postoperative complications and length of hospitalization.

Key words: goal?directed fluid therapy, cytoreductive surgery, hyperthermic intraperitoneal chemotherapy

摘要： 目的 探讨目标导向液体治疗（GDFT）在肿瘤细胞减灭术（CRS）联合腹腔热灌注化疗（HIPEC）中的应用效果。方法 采用前瞻性研究方法，选取我院腹膜转移瘤拟行 CRS 联合HIPEC 患者 86 例，分成对照组和观察组，每组 43 例。对照组患者围手术期行经典输液治疗，观察组患者行 GDFT。记录两组患者一般资料、术中血流动力学指标、手术结束时血乳酸水平、尿量、术中补液量、术中出血量及使用呋塞米和多巴胺情况、术后并发症、再次进入重症监护室（ICU）及死亡等情况。结果 两组患者一般资料差异无统计学意义（P>0.05）。观察组患者晶体补液量和总补液量显著低于对照组患者，胶体补液量显著高于对照组患者（P<0.05）。观察组患者手术结束后 30 min 平均动脉压显著低于对照组患者（P<0.05）。观察组术中使用呋塞米和多巴胺率、手术结束时血乳酸水平、住院时间、术后腹部、心脏、呼吸和肝脏并发症发生率和再进入ICU 率均显著低于对照组患者（P<0.05）。结论 GDFT 可有效减少 CRS 联合 HIPEC 患者术中补液量，降低术后并发症发生率，缩短住院时间。

关键词: 肿瘤细胞减灭术, 目标导向液体治疗, 腹腔热灌注化疗