目的 分析成人患者液体管理的研究热点和发展趋势。方法 检索中国知网和Web of Science数据库2011年—2021年成人患者液体管理的相关文献,采用CiteSpace 5.7.R2软件进行可视化分析。结果 共纳入得到中文文献506篇,英文文献1 801篇。液体管理相关研究发文量整体呈上升趋势,但英文文献发文量远高于中文文献发文量,2017年达发文量顶峰。关键词共现分析发现,研究热点集中于感染性休克、液体反应性、血流动力学监测等方面;通过聚类分析,中文文献形成心功能、容量管理、血流动力学、围手术期、中心静脉压、液体管理、感染性休克、质性研究、加速康复外科9个聚类;英文文献形成major abdominal surgery（腹部大手术）、historical cohort study（历史性队列研究）、acute kidney injury（急性肾损伤）、perioperative fluid management（围手术期液体管理）、fluid responsiveness（液体反应性）、colloid solution（胶体溶液）、cardiopulmonary resuscitation（心肺复苏）、emergency department patient（急诊科患者）、ill patient（患者）、controlled trial（对照试验）10个聚类;突现词“围手术期目标导向液体治疗”则体现了液体管理的研究前沿。结论 成人患者液体管理的研究对象聚焦于危重症患者,研究主题主要涉及血流动力学监测、液体反应性和静脉输液方面,围手术期目标导向液体管理为研究趋势,但研究多偏向于医疗领域,在护理领域有待拓展。
Objective To analyze the research hotspots and trends of fluid management in adult patients. Methods CiteSpace 5.7.R2 software was used to analyze the literature on fluid management in adult patients from 2011 to 2021 in China National Knowledge Infrastructure（CNKI） and Web of Science（WOS） core collection database. Results A total of 506 Chinese literatures and 1 801 English literatures were retrieved. The number of articles published on fluid management showed an overall upward trend,but the number of articles published in English was much higher than that in Chinese,and reached the peak in 2017. Keyword co-occurrence analysis showed that research hotspots focused on septic shock,fluid responsiveness and hemodynamic monitoring. The cluster analysis showed Chinese literature formed nine clusters including cardiac function,volume management,hemodynamics,perioperative period,central venous pressure,fluid management,septic shock,qualitative research and enhanced recovery surgery. English literature formed 10 clusters,including major abdominal surgery,historical cohort study,acute kidney injury,perioperative fluid management,fluid responsiveness,colloid solution,cardiopulmonary resuscitation,emergency department patient,ill patient,controlled trial. The burst keyword “goal-directed fluid management in perioperative period” reflected the research frontier of fluid management. Conclusion The research objects focused on critically ill patients,and the research theme mainly involved hemodynamic monitoring,fluid responsiveness and intravenous infusion. The research trend is goal-directed fluid management in perioperative period,but the research tends to be medical,and needs to be expanded in the field of nursing.
[1] 赵玉沛,杨尹默,楼文晖,等. 外科病人围手术期液体治疗专家共识(2015)[J]. 中国实用外科杂志,2015,35(9):960-966.
Zhao YP,Yang YM,Lou WH,et al.Expert consensus on perioperative fluid management in surgical patients(2015)[J]. Chin J Pract Surg,2015,35(9):960-966.
[2] Acheampong A,Vincent JL.A positive fluid balance is an independent prognostic factor in patients with sepsis[J]. Crit Care,2015,19:251.
[3] Rogers C,Bush N.Heart failure:pathophysiology,diagnosis,medical treatment guidelines,and nursing management[J]. Nurs Clin North Am,2015,50(4):787-799.
[4] 吴前胜,胡凯利,李冰冰,等. 容量反应性护理领域研究热点及研究基础分析[J]. 中华急危重症护理杂志,2021,2(5):417-421.
Wu QS,Hu KL,Li BB,et al.Analysis of research hotspots on fluid responsiveness in nursing field[J]. Chin J Emerg Crit Care Nurs,2021,2(5):417-421.
[5] 卢歌玲,郑瑾. 基于CiteSpace的快速康复外科研究进展的可视化分析[J]. 中国医科大学学报,2020,49(11):1030-1034.
Lu GL,Zheng J.The visualized analysis of research improvement for enhanced recovery after surgery via CiteSpace[J]. J China Med Univ,2020,49(11):1030-1034.
[6] Makic MBF,Bridges E.CE:managing sepsis and septic shock:current guidelines and definitions[J]. Am J Nurs,2018,118(2):34-39.
[7] Chong MA,Wang YJ,Berbenetz NM,et al.Does goal-directed haemodynamic and fluid therapy improve peri-operative outcomes?:a systematic review and meta-analysis[J]. Eur J Anae-sthesiol,2018,35(7):469-483.
[8] Esposito S,de Simone G,Boccia G,et al. Sepsis and septic shock:new definitions,new diagnostic and therapeutic approaches[J]. J Glob Antimicrob Resist,2017,10:204-212.
[9] 万献尧,李文雯. 感染性休克患者的液体管理[J]. 医学与哲学(B),2017,38(2):23-27.
Wan XY,Li WW.The fluid management of septic shock patients[J]. Med & Philos B,2017,38(2):23-27.
[10] 赵鹏,李华英. 围手术期液体管理的研究进展[J]. 护士进修杂志,2017,32(11):1006-1008.
Zhao P,Li HY.Research progress of peri-operative liquid management[J]. J Nurses Train,2017,32(11):1006-1008.
[11] 胡世华,蒋文新,杨艳霞,等. 限制性液体管理对急性呼吸窘迫综合征患者的肺保护作用[J]. 广东医学,2014,35(18):2881-2884.
Hu SH,Jiang WX,Yang YX,et al.Lung protective effect of restricted fluid management in patients with acute respiratory distress syndrome[J]. Guangdong Med J,2014,35(18):2881-2884.
[12] Dries D.Fluid resuscitation:less is more[J]. Crit Care Med,2014,42(4):1005-1006.
[13] 邵英. 脉搏指示持续心输出量容量性指标在重症CRRT病人液体管理中的指导应用[J]. 全科护理,2021,19(27):3821-3824.
Shao Y.Application of volumetric index of pulse indicating continuous cardiac output in fluid management of patients with severe CRRT[J]. Chin Gen Pract Nurs,2021,19(27):3821-3824.
[14] 秦学东,刘鹏飞,王泉利. 脉搏指示连续心排血量监测技术在急性心力衰竭患者中临床应用[J]. 创伤与急危重病医学,2018,6(1):1-4.
15 Qin XD,Liu PF,Wang QL.Pulse indicating continuous cardiac output monitoring technique for patients with acute heart failure[J]. Trauma Crit Care Med,2018,6(1):1-4.
[15] 张靓靓,王永杰,宋海涛,等. 血管外肺水指数和胸腔内血容积指数在感染性休克合并ARDS患者液体管理中的指导意义[J]. 中国老年学杂志,2014,34(22):6305-6307.
Zhang LL,Wang YJ,Song HT,et al.Significance of extravascular lung water index and intrathoracic blood volume index in fluid management of septic shock patients with ARDS[J]. Chin J Gerontol,2014,34(22):6305-6307.
[16] Memon AU,Ansari MI,Shaikh SA,et al.Fluid resuscitation in cardiogenic shock:an assessment of responsiveness and outcome[J]. J Ayub Med Coll Abbottabad,2021,33(3):471-474.
[17] Aluisio AR,Yam D,Peters JL,et al.314 treatment with intravenous fluid therapy was not associated with improved survival among patients with Ebola virus disease:an international multisite cohort study[J]. Ann Emerg Med,2018,72(4):S123-S124.
[18] Barlow A,Barlow B,Tang N,et al.Intravenous fluid management in critically ill adults:a review[J]. Crit Care Nurse,2020,40(6):e17-e27.
[19] Benes J.Intravenous fluid therapy in intensive care[J]. Anesteziologie a Intenzivni Medicina,2016,27(2):107-115.
[20] Machicado JD,Papachristou GI.Intravenous fluid resuscitation in the management of acute pancreatitis[J]. Curr Opin Gastroenterol,2020,36(5):409-416.
[21] Zhu AC,Agarwala A,Bao XD.Perioperative fluid management in the enhanced recovery after surgery(ERAS) pathway[J]. Clin Colon Rectal Surg,2019,32(2):114-120.
[22] Thacker JK,Mountford WK,Ernst FR,et al.Perioperative fluid utilization variability and association with outcomes:considerations for enhanced recovery efforts in sample US surgical populations[J]. Ann Surg,2016,263(3):502-510.
[23] Myles PS,Bellomo R,Corcoran T,et al.Restrictive versus liberal fluid therapy for major abdominal surgery[J]. N Engl J Med,2018,378(24):2263-2274.
[24] Shin CH,Long DR,McLean D,et al. Effects of intraoperative fluid management on postoperative outcomes:a hospital registry study[J]. Ann Surg,2018,267(6):1084-1092.
[25] Finfer S.Clinical controversies in the management of critically ill patients with severe sepsis:resuscitation fluids and glucose control[J]. Virulence,2014,5(1):200-205.
