高渗晶体/胶体液在围手术期改善第三间隙积液的临床研究  

Effects of hypertonic saline/colloid on the effusion of third space during perioperative period

作　　者：麦威[1] 满晓波[2] 黄顺荣[1] 徐胜[1] 秦千子[1] 牙韩清[1] 朱州[1] 毕连臣[1] 张贵年[1] 

机构地区：[1]广西壮族自治区人民医院胃肠外周血管外科,南宁530021 [2]第二军医大学附属东方肝胆医院,上海200438

出　　处：《中国临床新医学》2010年第4期299-301,共3页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：吴孟超医学科技基金会容量治疗专项基金资助项目(编号:C2005018)

摘　　要：目的探讨高渗晶体/胶体液在围手术期改善第三间隙积液的临床影响。方法对2006-08～2009-01间44例胃肠道癌根治术病人,研究组(n=22)输注高渗晶体/胶体液后续晶体液等常规治疗,对照组(n=22)仅给予常规治疗。比较两组病人的输液量、尿量、液体平衡、血浆总蛋白及白蛋白的变化。结果两组病人术中、术后第一个24h、术后第二个24h、术后第三个24h的输入液量、术前及术后第1天总蛋白、白蛋白比较差异无统计学意义(P>0.05)。术中及术后第三个24h尿量差异也无统计学意义(P>0.05)。但两组术后第一个24h和术后第二个24h的尿量差异有统计学意义(P<0.05),即研究组术后第一个24h尿量明显较对照组多,对照组术后第二个24h尿量较研究组多。结论高渗晶体/胶体液临床用药安全,在胃肠道癌根治术围手术期具有促进尿量峰值提前出现、明显改善减少第三间隙积液的作用。Objective To study the effects of hypertonic saline/colloid on fluid balance and clinical outcome during perioperative period. Methods forty-four patients with gastrointestinal carcinoma undergoing radical surgery were studied. The pairing patients were assigned to receive either hypertonic saline/colloid （the experimental group, n = 22） or conventional solution（ the control group, n = 22 ）during the early postoperative period. Fluid infusion volumes, urine outputs, as well as total plasma protein, total albumin were compared between the two groups. Results Urine outputs during the first postoperative 24 hours in experimental group were significantly more than that in control group, but urine outputs in the third postoperative 24 hours in experimental group were significantly less than that in control group （P 〈 0. 05）. Fluid infusion volumes during the operation, the first postoperative 24 hours, the second postoperative 24 hours and second postoperative 24 hours in experimental group were no significantly different from that in control group（P 〉 0. 05）. Urine outputs during the intrapostoperativeperiod and the third postoperative 24 hours were no significantly different from that in control group（P 〉0.05）. Total protein and total albumin on the properative day and the first postoperative day in experimental group were no significantly different from that in control group（P 〉 0. 05）. Conclusion Hypertonie saline/colloid has an intense diuretic effect, which could accelerate appearance of the top of urine outputs more early after the surgery, as well as reduce the effusion of third space after radical surgery for gastrointestinal carcinoma.

关 键 词：高渗液 液体平衡 围手术期 

分 类 号：R459.3[医药卫生—治疗学]