限制性静脉补液在肝移植术后早期的应用

目的探讨肝移植术后早期正确静脉补液的方法和规律。方法采用前瞻、随机、对照的方法,将13例肝移植患者分为限制性静脉补液组(A组)和常规静脉补液组(B组)。监测手术当日至术后第5天的入液量、尿量、胸腹水量,并记录与心、肺、脑相关的并发症。结果术后A组的入液量明显低于B组(P<0.05);术后第1天两组间尿量差异无统计学意义,第2~5天A组尿量多于B组(P<0.05);术后第1~4天,A组的胸水量明显少于B组(P<0.05);术后第1~3天,A组腹水量明显少于B组(P<0.05);A组中出现并发症的比例明显低于B组(P<0.05)。结论限制性静脉补液有利于减轻肝移植术后早期胸腹水的积聚,减少并发症的发生。

Study on the application of intravenous fluid restriction in the early stage after liver transplantation

Objective To explore the optimum regime for intravenous fluid therapy in the early stage after liver transplantation. Methods It was applied a prospective randomized single-blinded trial. Thirteen patients undergoing liver transplantation were randomly divided into two groups: group A in which intravenous fluids were restricted strictly, group B in which intravenous fluids were administered as usually. The intravenous fluid uptake, urine output, hydrothorax, ascites and cardiopulmonary-cerebral complications from the day on operation to the 5th day after operation were monitored. Results Intravenous fluid uptake in group B was more than that in group A after operation(P<0.05). There was no significance in urine output between the two groups in the first day after operation.But from 2nd to 5th day after operation the urine output in group A was more than that in Group B(P<0.05);the amount of hydrothorax in group B was more than that in group A significantly from 1st to 4th day after operation(P< 0.05 ), so was the amount of ascites from 1st to 3rd day after operation(P<0.05). The ratio of patients with complications from group A was lower than that from group B(P<0.05). Conclusion Intravenous fluid restriction after liver transplantation could help to lessen the ascites and hydrothorax,prevent the occurrence of complications.