继发性腹膜炎围手术期液体正平衡与APACHE Ⅱ评分的相关性  

The correlation between perioperative positive fluid balance and APACHEⅡ score of the patients with secondary peritonitis.

作　　者：邵永胜[1] 张应天[1] 彭开勤[1] 全卓勇[1] 龚少敏[1] 

机构地区：[1]江汉大学附属医院普通外科,武汉430015

出　　处：《中国实用外科杂志》2003年第2期93-95,共3页Chinese Journal of Practical Surgery

摘　　要：目的　探讨继发性腹膜炎 (SP)急诊手术围手术期液体正平衡与APACHEⅡ评分的关系。方法　根据APACHEⅡ评分 ,将 4 5 5例SP连续病例分为轻症 (<8分 )、重症 (8～ 19分 )和危重病例 (≥ 2 0分 )三组 ,比较三组病例术前、术日和术后第 1日的液体正平衡量。结果　轻症、重症和危重病例术前的液体正平衡量分别为(10 2 4 6 0± 4 0 2 5 7)mL、(2 2 5 8 5 8± 84 4 6 9)mL和 (3392 6 7± 983 31)mL(P <0 0 1) ;术日液体正平衡量分别为 (2 0 0 1 4 0± 716 6 4 )mL、(394 8 2 5± 10 2 4 0 4 )mL和 (5 6 4 1 6 7± 12 4 3 87)mL(P <0 0 1) ;术后第 1日液体正平衡量分别为 (814 5 8± 5 4 7 2 8)mL、(110 9 11± 6 6 7 5 1)mL和 (14 84 78± 72 1 0 4 )mL(P <0 0 1)。结论　无论是术前、术日或术后第 1日 ,SP病例的液体正平衡量与其APACHEⅡ评分正相关。可根据APACHEⅡ评分估测SP病例的液体正平衡量 ,指导其围手术期的液体治疗。Objective To evaluate the correlation between perioperative positive fluid balance and APACHEⅡ score of the patients with secondary peritonitis , who underwent emergent laparotomy.Methods According to APACHEⅡ score on admission , 455 consecutive patients with secondary peritonitis were divided into three groups : mild group ( the score<8 ) , severe group ( the score 8～19 ) and critical group ( the score≥ 20 ) . The volumes of perioperative positive fluid balance were compared among the three groups.Results The volume of positive fluid balance of mild , severe and critical cases was respectively (1024 60±402 57)mL , (2258 58±844 69)mL and (3392 67±983 31)mL ( P< 0 01 ) before operation.It was respectively (2001 40±716 64)mL , (3948 25±1024 04)mL and (5641 67±1243 87)mL (P< 0 01 ) in operative day.It was respectively (814 58±547 28)mL , (1109 11±667 51)mL and (1484 78±721 04)mL (P< 0 01 ) on the first day after emergent laparotomy. Conclusion There is significant positive correlation between the volume of perioperative positive fluid balance and APACHEⅡ score of patients with secondary peritonitis . APACHEⅡ score can estimate the volume of perioperative positive fluid balance and direct fluid therapy of the patients with secondary peritonitis.

关 键 词：继发性腹膜炎 围手术期 液体正平衡 APACHEⅡ 评分 相关性 

分 类 号：R656.41[医药卫生—外科学]