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目的:观察结直肠癌手术围术期限制性输液对术后转归的影响。方法:将结直肠癌手术患者90例随机分为非限制输液组和限制输液组各45例,非限制输液组中心静脉压(CVP)维持在(10±3)cmH2O,限制输液组CVP维持在(5±3)cmH2O,比较两组液体出入量、CVP、Hb、Ab、CRP、TNF-α和IL-6水平,以及术后首次排气、首次排便、住院时间和术后并发症发生情况。结果:限制性输液组输入液总量、输入复方氯化钠液量、输入万汶液量和术中尿量显著或非常显著少于非限制输液组(P<0.05或P<0.01);限制性输液组术毕CVP非常显著低于非限制输液组(P<0.01)。术后Hb、Ab水平较术前均有所下降,但非限制输液组术后降幅大于限制输液组;限制性输液组CRP、TNF-α和IL-6水平显著低于非限制输液组,术后第2天这种趋势更为显著(P<0.05)。限制输液组首次排气、首次排便时间显著早于非限制输液组(P<0.05);术后住院时间显著短于非限制输液组(P<0.01);术后并发症发生例数显著少于非限制输液组(P<0.01)。结论:结直肠癌手术围术期采用限制性输液安全、有效,有利于减少术后并发症和肠功能的恢复。
Objective: To observe the effect of perioperative restrictive infusion of colorectal cancer on postoperative outcome. Methods: 90 patients with colorectal cancer surgery were randomly divided into non-limited infusion group and limited infusion group of 45 patients. The CVP was maintained at (10 ± 3) cmH2O in the unrestricted infusion group, and CVP in the infusion group was limited to (5 ± 3) cmH2O. The levels of fluid excretion, CVP, Hb, Ab, CRP, TNF-α and IL-6 in the two groups were compared, as well as the first postoperative exhaust, first defecation, length of hospital stay and postoperative complications . Results: The total amount of infusion solution, the amount of compound sodium chloride solution, the amount of wenwen fluid and intraoperative urine output in the limited infusion group were significantly or very significantly less than those in the unrestricted infusion group (P <0.05 or P <0.01) The CVP of the transfusion group was significantly lower than that of the non-transfusion group (P <0.01). The postoperative Hb and Ab levels were lower than those before the operation, but the reduction rate in the non-limited infusion group was larger than that in the restricted infusion group. The CRP, TNF-α and IL-6 levels in the restricted infusion group were significantly lower than those in the non-restricted infusion group The second day after the trend is more significant (P <0.05). The first time of defecation was significantly shorter in infusion group than that in non-restricted infusion group (P <0.05), and the length of stay in hospital was significantly shorter than that in non-restricted infusion group (P <0.01). The incidence of postoperative complications was significantly less than Unrestricted infusion group (P <0.01). Conclusion: Perioperative management of colorectal cancer with restrictive infusion safe and effective, is conducive to reducing postoperative complications and recovery of bowel function.