羟乙基淀粉在老年胃癌根治术前应用的临床意义

Clinical application of hydroxyethyl starch in radical resection of gastric cancer in the old

目的探讨老年胃癌根治术患者术前使用观察的临床价值。方法选取2012年6月~2016年2月在台州市立医院胃肠外科接受胃肠外科接受胃癌根治术的54例患者进行临床研究,根据就诊单双号分为观察组、对照组各27例,术前均静脉注射射羟乙基淀粉或乳酸林格液,监测2组患者的血流动力学、炎症因子、凝血功能指标变化。结果 T0时刻,观察组、对照组的平均动脉压（mean arterial pressure,MAP）、中心静脉压（central venous pressure,CVP）、心率（heart rate,HR）值差异无统计学意义;在T1、T2、T3时刻,观察组的MAP、HR值高于对照组（P〈0.05）,CVP值低于对照组（P〈0.05）;在T1、T2、T3时刻,2组患者的PT、APTT值较T0时刻均显著的提高（P〈0.05）;治疗前,观察组、对照组的血清TNF-α、IL-10、IL-6、CRP差异无统计学意义;在给药后,观察组的血清肿瘤坏因子-α（tumor necrosis factorα,TNF-α）、白细胞介素-10（Interleukin,IL-10）、IL-6、C反应蛋白（C-reactive protein,CRP）值低于对照组（P〈0.05）。结论老年胃癌根治术患者术前使用观察对于维持患者血流动力学稳定、减轻术后炎症反应具有重要意义。

Objective To investigate the clinical value of elderly gastric cancer patients undergoing preoperative use of hydroxyethyl amylase.Methods From June 2012 to February 2016 underwent gastrointestinal surgery in our hospital 54 cases of radical resection of gastric cancer patients with clinical research,according to the patients divided into experimental group,control group 27 cases,preoperative intravenous hydroxyethyl starch or Ringer lactate solution,monitoring the hemodynamic changes,inflammatory factors and coagulation indexes in patients in two groups. Results T0 moment,MAP,CVP and HR of experimental group and control group were no significant difference; in T1,T2,T3,MAP and HR of experimental group were higher than that of control group（ P〈0. 05）,the CVP value was lower than the control group（ P〈0. 05）; T1 T2,T3,PT and APTT in two groups compared with T0 times were significantly increased（ P〈0. 05）; pre-treament,there was no significant difference in serum TNF-α,IL-10,IL-6 and CRP between the observation group and the control group; post-treament,The levels of TNF-α,IL-10,IL-6 and CRP in the observation group were lower than those in the control group（ P〈0. 05）. Conclusion The elderly gastric cancer patients undergoing preoperative use of hydroxyethyl amylase is important for inflammation and maintain stable hemodynamics in patients with postoperative.