摘要
目的探讨围手术期限制性液体治疗对巨大切口疝患者术后并发症和预后的影响。方法将87例巨大切口疝患者随机分为限制输液组（44例）和标准输液组（43例）。限制输液组患者术后连续3d输注液体，20ml／（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3d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。观察患者输液后肠、肝、心、肺、肾等功能的变化，观察腹腔压力（IAP）、生命体征及不良反应情况，比较两组患者并发症的发生率、病死率、住院时间、住院费用等差异。结果限制输液组患者输入液体总量、腹腔压力、术后总并发症发生率、和术后住院时间和费用均显著低于标准输液组（P〈0．05）。肠功能恢复时间差异无统计学意义（P〉0．05）。结论对巨大切口疝患者围手术期实施限制性液体治疗，有利于降低腹腔压力，减少术后并发症，缩短住院时间和降低住院费用。
Objective To investigate the effect of perioperative restricted intravenous fluid regi- men on postoperative complications and its prognosis in patients with huge incisional hernias. Methods A total of 87 patients were assigned to restricted group（ n =44）or standard group（ n =43 ）. According to the body weight,base deficit, serum lactic acid level, oxygenation index and additional fluid loss, each patient in the restricted group was treated with 20 mL/（ kg · d）of fluids for 3 days. According to the physiological requirement, intraoperative fluid requirement, body weight and central venous pressure （CVP） , each patient in the standard group received conventional treatment for 3 days. After the infusion, the changes of intes- tine, liver, cardio, lung, and kidney functions were investigated. Intra-abdominal pressure （ IAP ） , life signs and side-effects were observed. Postopertive complications,death rate,hospital stay and cost were compared between the two groups. Results Compared with the standard group, the total fluid volume, total postoper- ative complications, IAP, hospital stay and cost were significantly reduced in the restricted group. However, there were no significant differences in the incidence of heart failure, incision infection, lung infection, re- nal dysfunction and intestinal recover time between the two groups. Conclusion In the treatment of huge ineisional hernias, perioperative restrictive fluid management may be more beneficial, because it can de- crease the IAP, reduce the postoperative complications, shorten the hospital stay and lessen the expenses.
出处
《临床外科杂志》
2012年第10期721-723,共3页
Journal of Clinical Surgery
关键词
限制性液体治疗
巨大切口疝
术后并发症
restrictive fluid therapy
huge abdominal incisional hernias
postoperative com- plications
