快速流程模式中术后限制补液在老年结直肠癌患者中的应用价值  

Clinical Effect of Restrict Rehydration Strategy on Elderly Patients with Colorectal Cancer in Fast-Track

作　　者：肖凌[1,2,3] 黄真真[1,2] 李蔚[1,2,3] 薛瑛[1,2] 汪晓东[1,2] 李立[1,2] 

机构地区：[1]四川大学华西医院胃肠外科中心,成都610041 [2]四川大学华西医院MCQ团队,成都610041 [3]四川大学华西口腔医学院,成都610041

出　　处：《中国普外基础与临床杂志》2010年第1期87-91,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：四川省卫生厅科学研究项目(项目编号:090353)~~

摘　　要：目的探索在快速流程模式下术后限制补液在老年结直肠癌患者中的应用价值。方法回顾性研究2008年1月至2009年1月期间四川大学华西医院肛肠外科专业组收治的老年结直肠癌患者(≥60岁)的临床资料,分析比较采用不同补液方案(限制补液组和常规补液组)的临床疗效差异。结果限制补液组术后总并发症发生率明显低于常规补液组(P<0.05),其中吻合口漏和肺部感染的发生率明显低于常规补液组(P<0.05)。2组患者均无围手术期死亡发生。对于2组患者术后恢复情况,限制补液组患者的首次排气、排便和进食时间均早于常规补液组(P<0.05)。限制补液组和常规补液组患者术前GLU〔(6.70±2.93)mmol/L比(6.33±3.95)mmol/L〕、BUN〔(5.84±2.03)mmol/L比(7.32±10.83)mmol/L〕及CREA〔(76.19±19.85)μmol/L比(85.36±38.02)μmol/L〕的差异均有统计学意义(P<0.05),术后其差异则无统计学意义(P>0.05)。结论术后限制补液策略可以降低老年结直肠癌患者术后常见并发症的发生率并加速患者的康复。Objective To explore the effect of restrictive fluid administration on elderly patients with colorectal cancer in fast-track.Methods From January 2008 to January 2009,the elderly patients（≥60 years old） diagnosed definitely as colorectal cancer were analyzed retrospectively,the clinical effects on post-operative early rehabilitation were studied and the difference between restrictive fluid regimen and tradition fluid regimen was compared.Results The difference of overall incidence of post-operative complications was statistically significant between the two groups（P0.05）.The incidences of anastomotic leakage and pulmonary infection of fluid restriction group were lower than those of tradition therapy group（P0.05）.The time of vent to normal,defecation to normal and post-operative first eating of fluid restriction group was shorter than those of tradition therapy group,the difference was statistically significant（P0.05）.Comparing the biochemical indicators,the difference of pre-operative GLU（（6.70±2.93） mmol/L vs.（6.33±3.95） mmol/L）,BUN（（5.84±2.03） mmol/L vs.（7.32±10.83） mmol/L）and CREA（（76.19±19.85） μmol/L vs.（85.36±38.02） μmol/L）） was statistically significant（P0.05）,but the difference of postoperative results had no statistical significance.Conclusion Restrictive fluid regimen can reduce the incidence of common complications after colorectal surgery for elderly patients,and have a certain promoter action to the early rehabilitation after rectal surgery.

关 键 词：快速流程 液体管理 老年患者 结直肠肿瘤 

分 类 号：R735.3[医药卫生—肿瘤]