摘要
目的围手术期液体治疗往往使体重增加3~6 kg,有报道结直肠术后有68%的患者会发生并发症。最近研究表明限制性液体治疗可以改善胃肠大手术预后。文中观察限制性液体治疗和常规液体治疗对重度功能性便秘术后康复的影响。方法将2006年10月至2008年1月因重度功能性便秘需手术治疗的患者随机分为2组,分别进行常规液体治疗（常规组,n=36）和限制性液体治疗（限制组,n=37）。与常规组相比,限制组不常规补充手术麻醉引起血管扩张所要补充的液体量和围手术期第三间隙丢失量。观察2组液体治疗后住院时间、肠功能恢复时间、并发症、死亡率等的差异。结果限制性液体治疗组手术期间输注的液体量明显减少（P=0.001）,以晶体量减少为主（P〈0.001）。与常规组相比,术后并发症发生率减少[9例（24.3%）vs15例（41.7%）],其中全身并发症明显减少[7例（18.9%）vs13例（36.1%）,P=0.100],术后平均肠功能恢复时间明显缩短（2 dvs4 d,P=0.049）,平均住院时间显著减少（10 dvs13 d,P=0.041）。结论限制性液体治疗减少重度功能性便秘术后并发症,缩短住院时间,加速患者康复。
Objective Current fluid administration in major surgery causes a weight increase of 3-6 kg.Complications following colorectal surgery are reported in up to 68% of the patients.Recent evidence suggests that restricted perioperative fluid administration improves the prognosis after major elective gastrointestinal surgery.The authors investigated the effects of intravenous fluid restriction on the outcome of modified Duhamel operation for severe functional constipation.Methods We randomly assigned 73 patients treated by surgery for severe functional constipation to receive standard（the S group,n=36） or restricted（the R group,n=37） perioperative fluid administration,and compared the differences in hospital stay,enteric function recovery time and incidence of complications between the two groups.Results The R group showed a significant reduction in the perioperative intravenous fluid volume（P=0.001）,especially in crystalloid solution（P=0.001）,and it also exhibited a significantly decreased incidence of postoperative complications as compared with the S group（9/37 vs 15/36 ）,particularly in that of systemic complications（7/37 vs 13/36 ,P=0.100）.Intestinal movement recovery was obviously earlier in the R than in the S group（2 days vs 4 days,P=0.049）,and the hospital stay was remarkably shorter（10 days vs 13 days,P=0.041）.Conclusion Intravenous fluid restriction reduces complications,shortens hospital stay and facilitates the patient′s recovery after surgery for severe functional constipation,.
出处
《医学研究生学报》
CAS
2011年第2期158-162,共5页
Journal of Medical Postgraduates
基金
国家自然科学基金(30801086)
江苏省自然科学基金(BK2007573)
教育部博士点新教师基金(200802841005)
关键词
限制性液体治疗
重度功能性便秘
金陵术
并发症
Intravenous fluid restriction
Severe functional constipation
Jinling procedure
Complications
