改善微循环灌注在食管癌、贲门癌术后补液中的指导价值  

Study on the guiding value of improving microcirculation perfusion in esophageal cancer and postoperative fluid replacement of cardiac carcinoma

作　　者：罗洞波[1] 吕红博[1] 孙晓宏[1] 阿迪力.萨来 Luo Dongbo Lv Hongbo Sun Xiaohong et al(Department of Thoracic Surgery, Affiliated Cancer Hospital, Xinjiang Medical University, Urumqi 830011, China)

机构地区：[1]新疆医科大学附属肿瘤医院胸外科,乌鲁木齐830011

出　　处：《中华保健医学杂志》2016年第6期442-444,共3页Chinese Journal of Health Care and Medicine

基　　金：新疆维吾尔自治区引进境外技术管理人才项目(20166500024)

摘　　要：目的研究改善微循环灌注在食管癌、贲门癌术后补液中的指导价值。方法选取2014年2月-2016年4月于新疆医科大学附属肿瘤医院接受治疗的食管癌、贲门癌患者90例，以随机数字表法分为观察组与对照组各45例。观察组术后行改善微循环灌注补液，肠外营养液（PN）均采用全合一（all in one，AIO）方式，将多种氨基酸、脂肪乳、葡萄糖、微量元素、电解质、维生素等混合成AIO经中心静脉输注；对照组术后则行常规补液，对比两组补液效果。结果两组在补液前血乳酸以及平均动脉压水平对比无差异．在分别补液后观察组血乳酸水平低于对照组，而平均动脉压水平显著高于对照组（P〈0．05）；观察组补液后出现吻合口瘘、胃排空障碍以及心律失常等并发症的比例显著低于对照组（P〈0．05）；两组在补液前CD4＋、CD8＋、IL-6、IFN-γ水平对比无差异，补液后观察组CD4＋、CD8＋、IL-6、IFN-γ均显著优于对照组（P〈0．05）。结论改善微循环灌注在食管癌、贲门癌术后补液中具有较高的指导价值，安全性好，值得临床推广应用。Objective To study the value of improving microcirculation perfusion in esophageal cancer and postoperative fluid infusion in patients with cardiac carcinoma. Methods From February 2014 to April 2016, 90 patients with esophageal and cardiac carcinoma were treated in our hospital. They were randomly divided into the observation group and the control group, with 45 cases in each group. The observation group underwent improved mieroeirculation perfusion fluid infusion,all-in-one （AIO） parenteral nutrition （PN）,a variety of amino acids, lipid,glucose,electrolytes,trace elements,and vitamins mixed into AIO by central venous infusion. The control group was treated with routine fluid infusion after the operation, and the two groups were compared. Results Before the rehydration of blood lactic acid, the mean arterial pressure level showed no differences between the two groups. After rehydration, the blood lactate level was lower in the observation group than in the control group, and the mean arterial blood pressure was significantly higher in the observation group than in the control group. Rehydration after anastomosis fistula, the proportion of gastric emptying and arrhythmia were significantly lower in the observation group than in the control group. Before rehydration, the levels of CD4＋, CD8＋,IL-6,IFN -γ showed no difference between the two groups, but after rehydration, CD4＋, CD8＋,IL-6,IFN - γ were significantly higher in the observation group than in the control group. The differences were statistically significant （P 〈 0.05 ）. Conclusion The improvement of perfusion of the microcirculation in esophageal cancer and gastric cardia cancer after surgery with good guidance and safety should be considered for clinical application.

关 键 词：改善微循环灌注 食管癌 贲门癌 术后补液 

分 类 号：R457.2[医药卫生—治疗学]