食管癌围术期容量治疗与预后

The improved methods of perioperative volume therapy patients with esophageal cancer

目的探讨在食管癌患者围术期开展的容量治疗和预后。方法对本院自2004年1月至2011年1月间收治的80例食管癌患者临床资料、容量治疗手段和患者术后恢复情况进行回顾性分析,总结食管癌患者的围术期容量变化特征,进而探讨食管癌围术期容量治疗的方法。结果食管癌患者在围术期的容量平衡水平与患者食管癌病程、失血情况、输液量、肾功能及尿量密切相关。患者在术前多存在容量负平衡状态、术中补液状态下容量呈现正平衡,但是术后70.3%患者再次出现负平衡。术后液体负平衡患者并发症发生率低于正平衡患者(P<0.05)。结论对将要进行手术的食管癌患者,评估其容量平衡状况,科学正确给予优化的容量治疗,可以显著改善患者的手术恢复,减低并发症发生率。

Objective To discuss how to improve perioperative volume therapy for patients with esophageal cancer.Methods Eighty cases undergoing esophageal cancer surgery from January 2004 to January 2011 were included.The perioperative volume management methods and the postoperatively recovery of patients were retrospectively analyzed.Results The volume balance in the perioperative period for patients with esophageal cancer varied much,depending on the grade of cancer,blood loss,the fluid infusion,urine output and the function of kidney.Most patients showed a negative balance status preoperatively,while during surgery,fluid infusion turned the patients to a positive balance status.And 70.3％ of patients turned back to negative status postoperatively.The complications of these patients were significantly less than those with positive balance status （P＜ 0.05）.Conclusion For patients for esophageal cancer surgery,it is suggested to make a full evaluation of the fluid balance.To keep the balance of fluid could reduce the complications and effectively improve the recovery after the surgery.