摘要目的 探讨目标导向液体治疗对老年胃癌根治术患者术后并发症的影响价值. 方法 将2014年1月至2015年12月在我院行胃癌根治术的156例老年高血压患者按照随机数字表法分为常规组和目标组,常规组患者予以常规输液,目标组患者术中采取目标导向液体治疗,并比较两组患者手术中液体出入量、住院时间、血管活性药物使用率以及术后1个月内并发症发生率. 结果 目标组和常规组患者胶体量(832.3±216.6) ml和(1 031.3±245.8) ml、晶体量(1 157.6±149.2)ml和(1 559.8±201.4)ml、总体液体补充量(1 940.2±328.9)ml和(2 650.0±276.6)ml、住院时间(9.8±1.1)d和(12.5±2.0)d(t=-5.607、13.771、-18.021、-10.447,均P=0.000);常规组患者血管活性药物使用为69.2％(54/78)高于目标组29.5％(23/78)(x2=24.645,P=0.000);术后1个月内常规组并发症发生率为12.8％(10/78),高于目标组3.8％ (3/78)(x2=4.112,P=0.043). 结论 目标导向液体治疗有助于提高行胃癌根治术的老年患者预后,降低患者术后并发症的发生、促进患者早日康复.

abstractsObjective To analyze effects of target-oriented liquid therapy on postoperative complications in elderly hypertensive patients with radical gastrectomy.Methods 156 elderly patients with hypertension who underwent radical gastrectomy in our hospital from January 2014 to December 2015 were divided into the conventional group and the target group according to a random number table.Routine infusion was given to the patients in the conventional group,while the patients in the target group were treated with intraoperative target oriented liquid therapy.Intraoperative liquid intake and output volume,hospital stay,vasoactive drug use rate and the incidence of complications within 1 month after surgery were compared between the two groups.Results Target group versus conventional group showed that the colloid volume was(832.3 ± 216.6) ml vs.(1 031.3±245.8) ml,the amount of crystals was(1 157.6±149.2) ml vs.(1 559.8±201.4) ml,the total fluid replenishment was(1 940.2 ± 328.9) ml vs.(2 650.0 ± 276.6) ml,the hospitalization time was (9.8 ± 1.1) d and (12.5 ± 2.0) d (t =-5.607,-13.771,-18.021 and-10.447,respectively,all P=0.000).The use rate of vasoactive drugs was higher in the conventional group[69.2％ (54/ 78)] than in the target group [29.5 ％ (23 / 78)] (x2 =24.645,P =0.000).The complications within 1 months after surgery was higher in the conventional group[12.8％ (10/78)]than in the target group[3.8％ (3/78)] (x2=4.112,P=0.043).Conclusions Target-oriented liquid therapy can improve the prognosis of elderly patients receiving radical gastrectomy,reduce the incidence of postoperative complications and promote the early rehabilitation.