围手术期限制性液体治疗对老年病人术后并发症和预后的影响  

Effect of perioperative restrictive fluid treatment on postoperative complication in elder patients

作　　者：俞瑞东[1] 陆小川[1] 宋晓华[1] 胡勇杰[1] 韩冰[1] 陈贞[1] 唐健雄[2] 

机构地区：[1]复旦大学附属华东医院SICU,上海200040 [2]复旦大学附属华东医院普外科,上海200040

出　　处：《中国实用外科杂志》2012年第10期853-855,共3页Chinese Journal of Practical Surgery

摘　　要：目的探讨围手术期限制性液体治疗对老年病人术后并发症和预后的影响。方法将复旦大学附属华东医院2010年1月至2011年12月因胃肠疾病须行择期手术65例年龄>65岁的腹部手术病人随机分为限制输液组(n=33)和标准输液组(n=32)。限制输液组病人术后依据体重、碱缺失、血清乳酸水平、血氧合指标及其额外丢失量连续3d输注液体,20mL(/kg·d),标准输液组术后按照生理需求量、术中丢失量、额外丢失量、体重、中心静脉压(CVP)、尿量等常规补液,连续3d输注液体。观察病人输液前后肠、心、肺、肾等功能的变化,观察生命体征及不良反应情况,比较两组病人并发症的发生率、病死率、住院时间、住院费用等差异。结果限制输液组病人输入液体总量、术后总并发症发生率、术后住院时间和费用均显著低于标准输液组(P<0.05)。限制液体组病人心功能衰竭、肺部感染、伤口感染发生率和肠功能恢复时间与标准输液组比差异均无统计学意义(P>0.05)。结论对老年腹部手术病人围手术期实施限制性液体治疗,有利于减少术后并发症,缩短住院时间和降低住院费。Objective To compare the outcome of restricted or standard intravenous fluid regimen in perioperative elder patients. Methods This study was designed as a prospective and randomized controlled trial. After informed consent was obtained, patients were allocated to either restricted or standard fluid regimen group. The primary end point was postoperative complications, including intestinal, heart, renal、 and respiratory function, and the death rate, hospital stay and cost were also observed. Results A total of 65 patients were assigned to restricted group（n=33） or standard group（n=32）. The total fluid volume, total postoperative complications, hospital stay and cost were significantly reduced in restricted group when compared with those in standard group. However, there were no significant differences on the incidence of heart failure, lung infection, incision infection ,and intestinal recover time between two groups. Conclusion For elder patients who undergo elective surgery, perioperative restrictive fluid management may be more beneficial, because it would reduce total postoperative complications and decrease hospital stay and expenses.

关 键 词：限制性液体治疗 老年病人 术后并发症 

分 类 号：R6[医药卫生—外科学]