择期腹部手术患者术前补液临床研究

A Clinical Trail of Fluid Loading in Patients Undergoing Elective Abdominal Surgery

目的探讨术前补液对择期全麻腹部手术患者术中血流动力学及术后住院时间的影响。方法纳入择期全麻腹部手术患者82例,补液组和对照组各41例。补液组术前6小时内匀速静脉滴注乳酸林格氏液20mL/kg,对照组不做液体干预。比较两组术中血流动力学改变及术后住院时间。结果①补液组术中MAP与术前基础值相比差异无统计学意义;对照组全麻诱导后、插管后、插管后10min平均动脉压较术前基础值显著降低(P<0.05)。②补液组术后住院时间(12.2±11.5)d,与对照组(17.4±20.0)d相比显著减少(P<0.05)。结论术前6小时匀速补充20mL/kg晶体溶液,可以使择期全麻腹部手术患者术中血流动力学更稳定,并缩短住院时间。

Objective To evaluate the effects of pre-operative fluid loading in patients undergoing elective abdominal surgery under general anesthesia. Methods 82 patients undergoing elective abdominal surgery under general anesthesia were enrolled. The patients were randomly divided into pre-operative fluid loading group （n = 41） and control group （n = 41）. Pre-operative fluid loading were infused 20 ml/kg of ringers lactate solution in six hours before surgery. The control group had no pre-operative fluid loading. MAP and HR were determined before anesthesia （T1）, after anesthesia （T2）, after intubation （T3） and 10 minute after intubation （T4）. The number of hospital days after surgery of two groups was also compared. Results ①MAP of Wt had no significant difference with T2, T3 and T4 in pre-operative fluid loading group. MAP of T1, T2 and Ta was lower than T1 respectively in control group, P 〈0.05. ②The pre-opemtive fluid loading group had less hospital days after surgery than control group [（12.2 ± 11.5） d vs. （17.4 ± 20.0） d], P 〈0.05. Conclusions Pre-operative intravenous fluid loading leads to stable hemodynamic and reduction in hospital length of stay.