目标导向性液体治疗对老年患者腹部外科手术的影响

Effect of goal-directed fluid therapy on abdominal surgery in elderly patients

目的探讨目标导向性液体治疗对老年患者腹部外科手术的影响。方法选取2013年5月~2014年11月行腹部外科手术老年患者44例,随机分成目标导向性液体治疗组（A组）和传统液体治疗组（B组）。比较两组患者术中补液量、每分钟尿量、出血量;术后第1天红细胞比容（HCT）、肌酐（CR）、尿素氮（BUN）;手术后排气时间、住院天数、并发症发生情况。结果 A组术中补液量、每分钟尿量明显少于B组,差异有统计学意义;A、B两组术中出血量差异无统计学意义;两组患者在术后第1天HCT、CR、BUN差异无统计学意义;A组患者术后排气时间及住院天数均少于B组患者,差异有统计学意义,两组患者术后并发症的发生率差异无统计学意义。结论在老年患者中,基于每搏输出量的变异度（SVV）的目标导向性液体治疗,术中补液合理,术后肠道功能恢复快,住院时间短,比传统液体治疗更加安全可靠。

Objective To investigate the effect of goal-directed fluid therapy on elderly patients undergoing abdominal surgery. Methods A total of 44 elderly patients who received abdominal surgery in our hospital during May 2013 and Nov 2014 were divided into two groups： goal-directed liquid treatment group（ group A） and conventional treatment group（ group B）. The patients＇ clinical data were analyzed,including volume of fluid input,volume of urine per minute,intraoperative blood loss,hematocrit（ HCT）,creatinine（ CR）,blood urea nitrogen（ BUN） on the first day after operation,exhaust time,hospitalization time,and complications. Results The volume of fluid input,volume of urine per minute,exhaust time,and hospitalization time for group A were significantly less / shorter than those for group B.There were no statistical differences in the other indexes between the two groups. Conclusion Goal-directed fluid therapy based on stroke volume variation（ SVV） was safer and more reliable than traditional liquid treatment for elderly patients,because the volume of fluid input was more reasonable,and bowel functions recovered sooner.