限制补液策略有利于结直肠癌伴糖尿病患者术后的早期安全康复  

Clinical Effect of Restrict Rehydration Strategy for Patients with Colorectal Cancer Combined Diabetes

作　　者：李蔚[1,2,3] 肖凌[1,2,3] 余曦[1,2,4] 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 [4]四川大学华西临床医学院,成都610041

出　　处：《中国普外基础与临床杂志》2010年第4期399-402,共4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：目的探究限制补液策略对结直肠癌伴糖尿病患者术后早期康复的临床价值。方法回顾性研究2007年1月至2009年10月期间四川大学华西医院结直肠外科专业组收治的伴糖尿病的结直肠癌患者的临床资料,分析比较采用不同补液方案(限制补液组和常规补液组)的术后首次排气、进食、下床活动及住院时间,术后早期并发症(伤口感染、吻合口漏、肠梗阻),生化与血常规检查指标(血红蛋白、白细胞计数、葡萄糖、尿素氮)。结果限制补液组术后首次排气及下床活动时间均早于常规补液组(P<0.05),而2组术后首次进食、术后住院时间的差异无统计学意义(P>0.05)。在术后早期并发症方面,限制补液组的伤口感染率明显低于常规补液组(P<0.05),而2组间吻合口漏及肠梗阻发生率差异无统计学意义(P>0.05)。生化与血常规检查指标,术前2组患者各指标的差异均无统计学意义(P>0.05);术后限制补液组葡萄糖水平明显低于常规补液组(P<0.05),其余指标2组间差异无统计学意义(P>0.05)。结论术后限制补液策略可以降低伴糖尿病的结直肠癌患者术后常见并发症的发生率并有利于患者的康复。Objective To explore the impact of restrictive fluid administration for patients with colorectal cancer combined diabetes.Methods The clinical data of patients diagnosed definitely as colorectal cancer with diabetes were analyzed retrospectively from January 2007 to October 2009 in this hospital,the clinical effects on postoperative early rehabilitation were studied and the differences between restrictive fluid regimen （fluid restriction group） and tradition fluid regimen （tradition therapy group） were compared.Results The time of first aerofluxus and the first ambulation in fluid restriction group were shorter than those of tradition therapy group,the differences had statistical significances （P0.05）.The incidence of wound infection in fluid restriction group was lower than that in tradition therapy group （P0.05）.The differences of preoperative hemoglobin （Hb）,white blood cell （WBC）,glucose （GLU） and blood urea nitrogen （BUN） were not statistically significant between two groups,but the difference of postoperative GLU was statistically significant between two groups （P0.05）.Conclusion Restrictive fluid regimen can reduce the incidence of common complications after colorectal surgery for diabetic,and has a certain promoter action to the early rehabilitation after rectal surgery.

关 键 词：液体管理 糖尿病 结直肠肿瘤 快速流程 

分 类 号：R735.3[医药卫生—肿瘤] R587.1[医药卫生—临床医学]