消化系统恶性肿瘤根治术患者术后早期目标导向治疗的效果  

Efficiency of early goal-directed therapy after digestive system tumor radical operation

作　　者：杨奕[1] 陈冀衡[2] 李青[1] 王宏志[1] 任宏[1] 杨乃众[1] 

机构地区：[1]北京大学临床肿瘤学院北京肿瘤医院暨北京市肿瘤防治研究所ICU,100036 [2]北京大学临床肿瘤学院北京肿瘤医院暨北京市肿瘤防治研究所麻醉科,100036

出　　处：《中华麻醉学杂志》2008年第3期246-248,共3页Chinese Journal of Anesthesiology

摘　　要：目的 探讨消化系统恶性肿瘤根治术患者术后实施早期目标导向治疗（EGDT）的效果。方法 择期消化系统恶性肿瘤根治术患者186例，麻醉恢复后立即转入ICU，随机分为2组：对照组（n=89）和EGDT组（n=97），对照组术后常规补液（晶体和胶体）治疗，EGDT组术后8h内行EGDT，即在CVP、MAP、中心静脉血氧饱和度及尿量的指导下，进行滴定式液体（晶体和胶体）治疗及应用血管活性药物。监测术后24h内心脏指数（CI）及氧供指数（DO2I），记录术后感染发生情况。结果 与对照组比较，EGDT组术后8h和24h CI和DO2I明显升高，ICU住院时间缩短，术后感染的发生率降低（P〈0．05或0．01）。结论 消化系统恶性肿瘤根治术后行EGDT有助于患者的术后恢复。Objective To investigate the efficiency of early goal-directed therapy （EGDT） on the hemodynamics,the incidence of postoperative infectious complications and duration of ICU stay after the digestive system tumor, radical operation. Methods One hundred and eighty-six patients after digestive system tumor radical operation in intensive care unit（ICU）, both sexes, aged 55 to 75 yr, were randomized into control group（ n = 89） and EGDT group （ n =97）. The control group received conventional fluid therapy, and the colloid and crystal solution were infused to maintain SpO2 〉 94 %, Hb 80-150 g/L, HR 60-100 bpm, MAP 100-150 mm Hg. The EGDT group received the vasoactive agents combined with conventional fluid therapy to maitain CVP 8-12 cm H2 O, MAP 60-100 mm Hg,urine volume 〉 0.5 ml·kg^-1·h^-1 and ScvO2 〉 70% in 8 h postoperatively. Results Compared with the control group, CI and DO2I were significantly increased, the duration of ICU stay and the incidence of postoperative infectious complications were reduced significantly in EGDT group. Conclusion EGDT can be helpful greatly for the patients recovery after digestive system tumor radical operation.

关 键 词：补液疗法 消化系统肿瘤 血液动力学现象 氧消耗 手术后并发症 

分 类 号：R735[医药卫生—肿瘤] R737.9[医药卫生—临床医学]