全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...
-  2017 

高渗氯化钠羟乙基淀粉目标导向液体治疗应用于高龄患者腹腔镜直肠癌根治术 Hypertonic Liquid Crystal Glue Goal-Directed Liquid Applied in Elderly Patients with Laparoscopic Colorectal Cancer Radical Treatment

Keywords: 高渗晶胶液,目标导向液体治疗,腹腔镜直肠癌根治术(Dixon),第三间隙

Full-Text   Cite this paper   Add to My Lib

Abstract:

目的:观察目标导向液体治疗输注不同液体对高龄患者行腹腔镜直肠癌根治术(Dixon)手术中的临床应用。方法:52例限期腹腔镜直肠癌根治术(Dixon)手术,ASAⅠ-Ⅱ级,随机分为两组,均采用目标导向液体治疗:L组为乳酸林格液+万汶组;H组为乳酸林格液+高渗晶胶液组,每组26例。局麻下行两创测平均动脉压(MAP)、中心静脉压(CVP),监测毎搏变异度(SVV)、心输出指数(CI)等指标。两组根据SVV、MAP、CI、心搏量指数(SVI)将CI≥2.5L/(min·m~2)作为目标行目标导向液体治疗;监测并记录入室建立监测时(T0)、麻醉诱导平稳10min时(T1)、麻醉后1h(T2)、麻醉后2h(T3)、麻醉后3h(T4)、麻醉苏醒拔管后10 min(T5)的MAP、HR、CVP、CI、SVV以及记录手术时间、晶体液量、胶体液量、尿量、出血量、多巴胺使用量。结果:两组相比,H组液体输注量明显减少(P<0.05),而尿量明显增多(P<0.05);两组在T2、T3、T4、T5时CI、MAP、CVP逐步升高,与T1相比明显升高有显著性差异(P<0.05);而两组组间比较无明显差异性(P>0.05)。结论:腹腔镜直肠癌根治术(Dixon)手术麻醉期行目标导向液体治疗输注高渗晶胶液能有效扩容、稳定高龄患者的血流动力学,提高心输出量,改善微循环,增加尿量,减少第三间隙的水钠潴留,提高了目标导向液体治疗的安全性、合理性,减少高龄患者围术期的并发症

References

[1]  王敏燕,陈志斌.预注高渗氯化钠羟乙基淀粉40液对血浆胶体渗透压和电解质的影响[J].实用医学杂志,2011,27(3):477-478.Wang MY,Chen ZB.Effect of pre-impregnated hypertonic sodium chloride hydroxyethyl starch solution on plasma colloid osmotic pressure and electrolyte[J].Journal of Practical Medicine,2011,27(3):477-478.
[2]  蒋海燕,李俊杰,李薇,等.目标导向液体治疗对高龄胃肠道肿瘤患者术后的影响[J].昆明医科大学学报,2015,36(12):100-103.Jiang HY,Li JJ,Li W,et al.Effect of Targeted Liquid Therapy on Postoperative Patients with Gastrointestinal Tract Cancer in the Elderly[J].Journal of Kunming Medical University,2015,36(12):100-103.
[3]  吴华,程娟,吴国翠,等.人血白蛋白对腹部外科手术患者预后影响的系统评价[J].中华疾病控制杂志,2015,19(11):1 162-1 166.Wu W,Cheng J,Wu GC,et al.Effect of human serum albumin on prognosis of patients undergoing abdominal surgery:a systematic review[J].Chinese Journal of Disease Control&Prevention,2015,19(11):1 162-1 166.
[4]  李权,陈琦,郭俊,等.每搏输出量变异度在脓毒症休克液体复苏治疗中的指导作用[J].武汉大学学报:医学版,2012,33(4):606-608.Li Q,Chen Q,Guo J,et al.The role of stroke volume variability in the management of septic shock fluid resuscitation[J].Medical Journal of Wuhan University,2012,33(4):606-608.
[5]  Brandstrup B,Tonnesen H,Beier-Holgersen R,et al.Effects of intravenous fluid restriction on postoperative complications:comparison of two perioperative fluid regimens[J].Ann Surg,2003,238(5):641-648.
[6]  王新颖,李宁,彭南海,等.混合糖电解质注射液在腹部中等以上手术病人术后补液中的应用[J].中国实用外科杂志,2007,27(12):990-992.Wang XY,Li N,Peng NH,et al.Application of mixed sugar electrolyte injection in postoperative rehydration of abdominal abdominal surgical patients[J].Chinese Journal of Practical Surgery,2007,27(12):990-992.
[7]  高礼,张山,孟雅静,等.高渗氯化钠羟乙基淀粉40注射液对中重度创伤性脑损伤手术患者的脑保护作用[J].临床麻醉学杂志,2015,31(9):842-845.Gao L,Zhang S,Meng YJ,et al.Protective effect of hypertonic sodium chloride hydroxyethyl starch 40injection on cerebral injury in patients with moderate to severe traumatic brain injury[J].The Journal of Clinical Anesthesiology,2015,31(9):842-845.
[8]  叶旻,夏芹,傅舒昆.霍姆高渗溶液对老年前列腺电切术中胶体渗透压和电解质的影响[J].同济大学学报:医学版,2010,31(2):78-79.Ye M,Xia Q,Fu SK.Effects of hypertonic solution on colloid osmotic pressure and electrolytes in senile prostate resection[J].Journal of Tongji University:Medical Science,2010,31(2):78-79.
[9]  赵国良,周银燕,彭沛华,等.目标导向液体治疗对胃肠道肿瘤手术老年患者术后康复的影响[J].中华麻醉学杂志,2015,35(4):453-456.Zhao GL,Zhou YY,Peng PH,et al.Effect of Targeted Liquid Therapy on Postoperative Rehabilitation in Elderly Patients with Gastrointestinal[J].Chinese Journal of Anesthesiology,2015,35(4):453-456.
[10]  陈莺,解春艳.高渗氯化钠羟乙基淀粉40对全身麻醉诱导期血流动力学的影响[J].广东医学院学报,2015,33(1):70-72.Cheng Y,Xie CY.Effects of hypertonic sodium chloride hydroxyethyl starch 40on hemodynamics during general anesthesia induction[J].Journal of Guangdong Medical College,2015,33(1):70-72.
[11]  Andersson L,Lindberg G,Bringman S,et al.Pneumoperitoneum versus abdominal wall lift:effects on central haemodynamics and intrathorecic pressure during laparoscopic cholecystectomy[J].Acta Anaestheaiol Scand,2003,47(7):838-846.
[12]  周涛,郭善亮.目标导向液体治疗在老年患者胃肠道手术中的应用[J].临床麻醉学杂志,2013,29(10):971-974.Zhou T,Guo SL.Application of target-directed fluid therapy in elderly patients with gastrointestinal surgery[J].The Journal of Clinical Anesthesiology,2013,29(10):971-974.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133