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目的观察限制性输液在老年结直肠癌患者腹腔镜手术中的应用效果。方法择期老年结直肠癌腹腔镜手术患者60例随机均分为两组,麻醉手术期间分别持续输注复方乳酸钠5ml·kg~(-1)·h~(-1)(A组)和25ml·kg~(-1)·h~(-1)(B组)。记录麻醉诱导前10min(T0)、诱导后10min(T1)、气腹头低位后10min(T2)、60min(T3)、90min(T4)和气腹消除平卧位15min(T5)的MAP、CVP、动脉血乳酸(LA)、中心静脉血氧饱和度(ScvO_2)和红细胞比积(Hct),检测T0、T2、T5和术后第1天(T6)、第3天(T7)和第5天(T8)血浆IL-6水平。结果两组T0~T3时的MAP、CVP、动脉血LA和Hct值均无统计学差异(P>0.05),各时点ScvO_2值亦相仿(P>0.05)。两组T2~T4时的CVP较T0增加(P<0.05);A组T5时的CVP值低于B组(P<0.05),T4、T5时的Hct值高于B组(P<0.05)。两组T3~T5时的LA均高于T0(P<0.05)。T5~T8时,A组的IL-6水平低于B组(P<0.05)。结论老年结直肠癌腹腔镜手术期间实施限制性输液可减轻炎症反应,有利于患者的术后康复。
Objective To observe the effect of restrictive infusion in laparoscopic surgery of elderly patients with colorectal cancer. Methods Sixty elderly patients with colorectal cancer undergoing laparoscopic surgery were randomly divided into two groups. During the operation, 5 mL · kg -1 · h -1 of compound sodium lactate (A group) and 25 mL · kg -1 kg ~ (-1) · h ~ (-1) (group B). The MAP and CVP were recorded before 10 minutes (T0), 10 minutes (T1), 10 minutes (T2), 60 minutes (T3), 90 minutes (T4) after pneumoperitoneum and 15 minutes (T5) Arterial blood lactic acid (LA), central venous oxygen saturation (ScvO_2) and hematocrit (Hct) were measured. T 0, T 2, T 5 and T 1, T 3 and T 5 (T8) plasma IL-6 levels. Results There was no significant difference in MAP, CVP, arterial LA and Hct between T0 and T3 (P> 0.05), ScvO_2 at each time point were also similar (P> 0.05). (P <0.05). The CVP of T5 in group A was lower than that in group B (P <0.05), and the value of Hct in T4 and T5 was higher than that in group B (P <0.05) . LA of T3 ~ T5 in both groups were higher than T0 (P <0.05). At T5 ~ T8, the level of IL-6 in group A was lower than that in group B (P <0.05). Conclusions The restrictive infusion during laparoscopic treatment of elderly patients with colorectal cancer can reduce the inflammatory reaction and is beneficial to the postoperative recovery of patients.