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1、7．5％高渗盐水对择期腹部大手术后全身性炎症反应的影响临床外科杂志2004年l1月第l2卷第ll期JClinSurg,November2004,Vo1.12,No.1l7.5%高渗盐水对择期腹部大手术后全身性炎症反应的影响赵建国彭开勤全卓勇邵永胜张应天[摘要]目的探讨7.5%高渗盐水对择期腹部大手术后全身性炎症反应的影响.方法连续52例择期腹部大手术病人,配对分为两组对比.术毕进入SICU后,研究组(n:26)应用7.5%高渗盐水(4ml/kg),后续平衡液;对照组(n:26)仅用平衡液.比较两组病人的液体平衡量,体重变化,Pa02/FiO2比值,
2、以及并发症发生率和死亡率.结果与对照组相比,研究组手术日和术后48h的液体正平衡量减少(P<0.001);术后体重增加幅度降低(P<0.001),体重下降时间提前(P<0.001);术后PaO,/Fio2比值较高(P:0.000111);术后总体并发症发生率和肺部感染发生率较低(P:0.0175,P:0.0374).结论7.5%高渗盐水可减少择期腹部大手术后的液体正平衡量,促进液体负平衡提前出现,有明显的抗炎作用.[关键词]高渗盐水;全身性炎症反应;液体正平衡;液体负平衡;腹部手术[中图分类号]R651[文献标识码]A[文章编号]
3、1005.6483(2004J11—0661.03Effectsof7.5%hypertonicsalineonsystemicinflammationresponseafterelectivema-jorabdominalsurgeryZHA0Jian—guo,PENGKai—qin,Q(4NZhuo-yong,ela1.(DepartmentofGeneralSurgery,theAffiliatedHospitalofJianghanUniversity,Wuhan430015,China)【AbsractjObjectiveToinvest
4、igatetheeffectsof7.5%hypertonicsaline(HS)onsystemicin-flammationresponseafterelectivemajorabdominalsurgery.MethodsFifty—twoconsecutivepatientsunder—goingelectivemajorabdominalsurgerywerestudied.ThepatientswereassignedtOreceiveeitherRingerlactatesolutionfollowing4ml/kgofHS(stud
5、ygroup,n:26)orRingerlactatesolution(controlgroup,n:26)duringtheearlypostoperativeperiodinthesurgicalintensivecareunit.Wecomparedfluidbalance,bodyweightchange,Pao2/Fio2values,thepostoperativemorbidityandmortalitybetweenthetwogroups.ResultsThevolumesofpositivefluidbalanceinopera
6、tivedayandduringthefirst48hoursfollowingsurgeryweresignificantlyloweramongpatientstreatedwithHSthanthoseincontrolgroup(P<0.000001).Bodyweightgainaftersurgerywassignificantlylesserinstudygroupthanincontrolgroup(P<0.000001).ThepostoperativePao2/Fio2valueswassignificantlyhi
7、gherinstudygroupthanincontrolgroup(P<0.000001).Conclusion7.5%HSucouldreducepositivefluidbal-ance,andacceleratenegativefluidbalanceappearancemoreearlyafterelectivemajorabdominalsurgery.7.5%HShadansignificantlyanti—inflammationeffect.1Keywordsjhypertonicsaline;systemicinflamm
8、ationresponse;positivefluidbalance;negativefluidbalance;abdom
