摘要
目的 探讨 7 5 %高渗盐水对择期腹部大手术后液体平衡的影响。方法 2 2例择期腹部大手术患者 ,配对分为两组。术毕进入外科ICU后 ,研究组 11例应用 7 5 %高渗盐水 4ml kg ,后续平衡液 ;对照组 11例仅用平衡液。比较两组患者的输液量、尿量、液体平衡和体重变化。结果 与对照组相比 ,研究组手术日和术后第 1天尿量较多 [(2 6 5 0± 5 31)mlvs (2 0 4 6± 5 72 )ml,t=2 5 5 17,P <0 0 5 ;(2 716± 6 4 0 )mlvs (2 2 32± 4 89)ml,t=2 2 878,P <0 0 5 ];术日和术后 4 8h的液体正平衡量较少[(40 5 8± 115 9)mlvs (5 92 2± 14 93)ml,t=2 870 1,P <0 0 5 ];(492 6± 2 6 98)mlvs (76 5 6± 2 5 4 3)ml,t=2 2 2 94 ,P <0 0 5 ];术后体重增加幅度低于对照组 [(5 0± 1 9)kgvs (7 2± 1 3)kg ;t=2 80 98,P <0 0 5 ];术后体重下降时间早于对照组 [(2 4 4± 3 4 )hvs (31± 5 )h ;t =3 382 6 ,P <0 0 1]。结论 7 5 %高渗盐水有明显的利尿作用 ,可动员、排出体内扣押的过多液体 ,减少择期腹部大手术后液体正平衡 ,促进液体负平衡提前出现。
Objective To investigate the effects of 7 5% hypertonic saline (HS) on fluid balance after elective major abdominal surgery Methods Twenty two patients undergoing elective major abdominal surgery were assigned to receive either Ringer lactate solution followed by 4 ml/kg of 7 5% HS (study group, n =11) or Ringer lactate solution (control group, n =11) during the early postoperative period in ICU We compared fluid infusion volumes and urine outputs, fluid balance, and body weight change between the 2 groups Results Urine outputs in the operative day and the first postoperative day in study group were significantly more than in control group [(2?650±531)ml vs (2?046±572)ml, t =2 551?7, P <0 05; (2?716±640)ml vs (2?232±489)ml, t =2 287?8, P <0 05] The volumes of positive fluid balance in operative day and during the first 48 hours following surgery were significantly lower among patients treated with HS than those in control group [(4?058± 1?159 )ml vs (5?922±1?493)ml, t =2 870?1, P <0 05; (4?926±2?698)ml vs (7?656±2?543)ml, t = 2 229?4 , P <0 05] Body weight gain after surgery was significantly lesser in study group than in control group [(5 0±1 9)kg vs (7 2±1 3)kg; t =2 809?8, P <0 05] The time of body weight recovery was significantly shorter in study group [(24 4±3 4)h vs (31 3±5 4)h; t =3 382?6, P <0 01] Conclusion 7 5% HS has strong diuretic effect, which could reduce positive fluid balance, and accelerate negative fluid balance after elective major abdominal surgery
出处
《中华普通外科杂志》
CSCD
北大核心
2004年第12期761-763,共3页
Chinese Journal of General Surgery
