摘要
目的 :探讨消化道穿孔 (DTP)急诊手术病例围手术期液体正平衡与APACHEⅡ评分的关系。方法 :根据APACHEⅡ评分 ,将连续 3 72例DTP病例分为轻症 ( <8分 )、重症 ( 8～ 19分 )和危重病例 (≥ 2 0分 ) 3组 ,比较 3组病例手术前、手术日和术后第 1日的液体正平衡量。结果 :轻症、重症和危重病例术前的液体正平衡量分别为 112 6.91± 414.80mL、2 3 60 .89± 85 7.0 3mL和 3 494.97± 995 .65mL(P <0 .0 1) ;手术日液体正平衡量分别为 2 10 3 .71± 72 8.99mL、40 5 0 .5 6± 10 3 6.3 7mL和 5 743 .95± 12 5 6.2 1mL(P <0 .0 1) ;术后第 1日液体正平衡量分别为 916.81± 5 5 9.62mL、12 11.43± 679.85mL和 15 87.0 9± 73 3 .3 8mL(P <0 .0 1)。结论 :无论是术前、手术当日或术后第 1日 ,DTP病例的液体正平衡量与其APACHEⅡ评分正相关。APACHEⅡ评分可估测DTP病例的液体正平衡量 。
Objective: To evaluate the relativity between perioperative positive fluid balance and APACHEⅡ score of the patients with digestive tract perforation, who underwent emergent laparotomy. Methods: According to APACHEⅡ score on admission, 372 consecutive patients with digestive tract perforation were divided into three groups: mild group (the score<8), severe group (the score 8～19) and critical group (the score≥20). The volumes of perioperative positive fluid balance were compared among three groups. Results: The volume of positive fluid balance of mild, severe and critical cases was respectively 1126.91± 414.80mL, 2360.89± 857.03mL and 3494.97± 995.65mL (P< 0.01) during preoperative phase, was respectively 2103.71± 728.99mL, 4050.56± 1036.37mL and 5743.95± 1256.21mL (P< 0.01) in operative day, was respectively 916.81± 559.62mL, 1211.43± 679.85mL and 1587.09± 733.38mL (P< 0.01) in the first day after emergent laparotomy. Conclusion: There is significant positive correlation between the volume of perioperative positive fluid balance and APACHE Ⅱ score of patients with digestive tract perforation. APACHEⅡ score can estimate the volume of perioperative positive fluid balance and direct fluid therapy of the patients with digestive tract perforation.
出处
《江汉大学学报（医学版）》
2002年第4期25-28,共4页
Journal of Wuhan Professional Medical College
