食管癌术后早期目标容量导向治疗对肺功能的影响  

Effect of the Early Goal Volume Directed Therapy on the Function of Lung in Postoperation of Esophagus Carcinoma

作　　者：袁欣[1] 王雁冰[1] 陈晓峰[1] 陈艾江 黄志斌 张江涛 赵娜[1] 

机构地区：[1]保定市第二中心医院,河北保定072750 [2]万全县卫生局,河北张家口075000

出　　处：《北华大学学报（自然科学版）》2013年第5期560-563,共4页Journal of Beihua University（Natural Science）

基　　金：保定市科学技术研究与发展计划项目(12zf113)

摘　　要：目的探讨食管癌术后早期目标容量导向治疗时肺功能的影响．方法100例胸段食管癌患行随机分为两组，每组符50例，J埘组术时准备、手术方式均相同，术后观察绀采用日杯容世导阳治疗，埘照组采川传统液体治疗．比较两组术后不同时间点的血氧分压（PaO2）、二氧化碳分压（PaCO2）、血氧饱和度（SaO2）、氧合指数（OI）、呼吸并发症（呼吸衰竭、8市不张、肺部感染）的发生率和术后每日液体平衡量（Fb）．结果 术后1～3dPaO2，SaO2，OI观察组〉对照组，PaCO2观察组〈对照组，P〈0．05；术后5d以后上述指标的差别无统计学意义．术后1～2d液体潴留量观察组〈对照组，P〈0．01；术后3～4d液体负平衡量观察绀〈对照组，P〈0．01；术后5d，两组无差别．术后1～5d体内液体潴留累计量与OI呈正相关，与PaCO2呈负相关．观察组术后呼吸衰竭的发牛率明显下降，P〈0．05，肺部感染和肺不张的发牛率尤明显差异．结论录用术后早期目标容量导向治疗可以减轻患者术n低氧血症，减少CO2潴留和呼吸衰竭等并发症的发生．Objective To evaluate the effect of early goal volume directed therapy on the function of lung in postoperation of esophagus carcinoma. Method 100 patients suffered from carcinoma of esophagus were separated Io 2 groups （50 patients each group） randomly,which were treated with the same way of preparation and operation. After the operation, the goal volume directed therapy were used in the treatment group and the traditional treatment in the control group. Several comparisons at different times were conducted between two groups, including PaO,, PaCO2, SaO2, oxygenation index （ OI ）, fluid balance, pulmonaU complications. Results During Ihc early 4 days after the operation,PaOe ,SaO2 and Ol in the treatment group were significantly better than those in the control group ;on day 5 after the operation the differences in all described indexes above between two group were not statistically significant;The fluid retention amount in the treatment group was less than that in the control group flom the 1 st to the 2nd day after the operation （P 〈 0.01 ） ; The negative fluid balance amount in the treatment group was less than that in the control group from the 3th to the 4th day after the operation（P 〈 0.01 ） ;however,there was no significant difference in the fluid retention amount and the negative fluid balance amount between the two groups after the 5th day after the operation. The fluid retention amount from 1st to the 5th day after the operation was positively correlated with OI, but negatively with PaCO2. After the operation, the incidence of respiratory failure in the treatment group declined obviously （P 〈 0.05 ） , and there was no significant difference in the incidence of pulmonary infection and atelectasis. Conclusion The early goal volume directed therapy in the postoperation of carcinoma of esophagus can decrease the incidence of hypoxemia, CO2 retention and respiratory failure.

关 键 词：食管癌 早期目标容量导向治疗 肺功能 

分 类 号：R735.1[医药卫生—肿瘤]