摘要
目的:探讨限制性液体治疗对炎症性肠病(IBD)病人术后并发症和预后的影响。方法:将87例IBD病人随机分为限制输液组(n=44)和标准输液组(n=43)。限制输液组病人术后连续3 d输注液体,20 ml/(kg.d),依据体重、碱缺失、血清乳酸水平、血氧合指标及其额外丢失量;标准输液组术后连续3 d输注液体,按照生理需求量、术中丢失量、额外丢失量、体重、中心静脉压(CVP)、尿量等常规补液。观察病人输液前后肠、肝、心、肺、肾、凝血等功能的变化,观察生命体征及不良反应情况,比较两组病人并发症的发生率、病死率、住院时间、住院费用等差异。结果:限制输液组病人输入液体总量、术后总并发症发生率、切口感染发生率和术后住院时间和费用均显著低于标准输液组(P<0.05)。限制液体组病人心力衰竭、休克、肺部感染、肾功能不全的发生率和肠功能恢复时间与标准输液组比均无显著性差异(P>0.05)。结论:对IBD病人围手术期实施限制性液体治疗,有利于减少术后并发症,缩短住院时间和降低住院费用。
Objective： To compare the outcome of restricted or standard intravenous fluid regimen in perioperative inflammatory bowel disease（IBD） patients.Methods： This study was designed as a prospective and randomized controlled trial.After informed consent was obtained,patients were allocated to either restricted or standard fluid regimen group.The primary end point was postoperative complications,including intestinal,liver,heart,respiratory,renal and clotting function,and the death rate,hospital stay and cost were also observed.Results： A total of 87 patients were assigned to restricted group（n=44） or standard group（n=43）.The total fluid volume,total postoperative complications,incision infection,hospital stay and cost were significantly reduced in restricted group when compared with those in standard group.However,there were no significant differences on the incidence of heart failure,shock,lung infection,renal dysfunction and intestinal recover time between two groups.Conclusion： For IBD patients who undergo elective surgery,perioperative restrictive fluid management may be more beneficial,because it would reduce total postoperative complications and decrease hospital stay and expenses.
出处
《肠外与肠内营养》
CAS
北大核心
2011年第6期351-354,共4页
Parenteral & Enteral Nutrition
基金
国家自然科学基金资助(30801086)
关键词
限制性液体治疗
炎症性肠病
术后并发症
Restrictive fluid therapy
Inflammatory bowel disease
Postoperative complication
