京津三级甲等医院普外科术后患者液体治疗现状初步调查

目的 调查京津三家三级甲等医院普外科术后患者液体治疗现状. 方法 回顾性调查接受普外科手术的住院且术后禁食3 d以上的患者600例,不限年龄和性别、所患疾病种类和接受的手术类型.统计指标包括患者的一般资料、手术前后实验室检查、术后3 d液体治疗内容和部分临床指标(术后并发症、输液反应等). 结果 588例有效病例术后每天平均补液总量为(3030±638)ml;平均每天给予葡萄糖(142±67)g、氯化钾(59.9±23.9)mmol、氯化钠(179.5±66.7)mmol;85.2%的患者接受营养支持,肠外营养与肠内营养比为28:1;术前体质指数(BMI)≥18.5 kg/m2的患者有549例,其中接受肠外营养和肠内营养支持共有470例(85.6%);BMI<18.5 kg/m2共39例,给予规范的肠外营养支持27例(69.2%).均未给予肠内营养.术后3 d液体治疗中未给予氯化钾36例次. 结论 京津三级甲等医院普外科术后患者接受营养支持和肠外营养的比例均过高;即用型复合糖电解质制剂可减少差错和有益于大多数术后患者.

Preliminary investigation of the current situation of postoperative fluid therapy in general surgery department of grade Ⅲ-A general hospitals in Beijing and Tianjin

Objective To investigate the current situation of postoperative fluid therapy in general surgery department of grade Ⅲ-A general hospitals in Beijing and Tianjin. Methods Postoperative patients in general surgery department who were fasting for 3 days were retrospectively investigated, and 600 cases were recruited without considering age, gender, denomination of disease and operation type. The general information of patients, laboratory examination before and after operation, postoperative fluid therapy for 3 days, postoperative complications and infusion reaction were collected. Results In total 588 valid cases, the volume of average fluids supplement was (3030±638)ml per day, With the prescribed glucose (142+67)g per day, potassium chloride (59.9±23.9) mmol per day and sodium chloride (179.5±66.7) mmol per day. 85.2 % of total patients received nutrition support and the ratio of parenteral nutrition/enteral nutrition (PN/EN) was 28/1.There were 549 patients with BMI>18.5 before operation, and among them, 470 cases (85.6%)received parenteral and enteral nutrition treatment. There were 39 patients with BMI < 18.5 and 27 cases (69.2%) received parenteral nutrition support without enteral nutrition treatment. During the 3 days after operation, there were 36 cases with fluid therapy without potassium chloride supplement.Conclusions The proportions of receiving nutrition support and parenteral nutrition treatment are relatively high in grade Ⅲ-A general hospitals in Beijing and Tianjin. Ready-to-use preparation canreduce mistake and will be benefit to patients.