目标导向液体治疗对高龄胃肠道肿瘤患者术后的影响.

Objective To investigate the effect of goal-directed fluid therapy （GDFT） on elderly patients after gastrointestinal surgery. Methods Sixty patients undergoing gastrointestinal tumor radical operation （age was no less than 60 years old， ASA Ⅱ OR Ⅲ） were included and randomly divided into two groups based on fluid therapy: conventional fluid therapy （group C） and goal-directed fluid therapy （group G） . Group C received conventional fluid therapy according to the change of blood pressure during operation，maintaining average arterial pressure at 60~110 mmHg. Whereas group G received goal-directed fluid therapy，we could get the stroke volume variation， cardiac index， and stroke volume index et al through the Flotrac/Vigileo. The goals of group G were maintaining stroke volume variation 2% ~13% ， cardiac index 2.5 ～4.0 L/(min.m)， stroke volume index 35~47 ml/m2，MAP 65~110 mmHg. Record the total volume of liquid， the crystal volume，and colloid volume. The first time of exhaust time after operation， total hospital stay， postoperative hospital stay and the total medical expenses were recorded. Results Compared with group C， patients in group G received less crystal solution and colloid solution. The incidence of postoperative pulmonary complications was lower. The first time of exhaust time after operation was earlier，postoperative hospital stay and total hospital stay was shorter， and the total medical expenses was less than group C. Conclusion GDFT can improve the prognosis in elderly patients after gastrointestinal surgery， reduce postoperative complications and save medical resources. [ABSTRACT FROM AUTHOR]