老年危重病患者围手术期电解质和体液的监测

目的研究老年危重病人围手术期的液体治疗对患者预后的影响。方法回顾性分析2003年-2007年外科监护室24例老年危重病人，根据预后分为死亡组与存活组，比较术前、术中、术后3d的出入水量，电解质，红细胞容积和乳酸等指标。结果存活组和死产组在术前、术中、术后3d的出入水量及红细胞容积的差异无统计学意义，术中存活组血钾高于死亡组，有统计学意义（P〈0．05）。术后第1天存活组的乳酸水平低于死亡组，差异有统计学意义（P〈0．05）。结论动态监测老年危重病人围手术期电解质、体液状态和乳酸水平对治疗和改善患者预后具有重要作用。

Peri-operative monitoring of electrolytes and body fluid in critically ill aged patients

Objective To investigate the effect of perioperative fluid therapy on prognosis of aged patients with critical illnesses. Methods 24 critically ill aged patients in SICU during 2003 to 2007 were analyzed retrospectively. They were divided into two groups by prognosis： death group and survival group. Pre-, peri- and post-operative intake and output, electrolytes, hematocrit and the lactic acid were compared between the two groups. Results There was no significant difference in pre-, peri- and post-operative intake and output, and hematocrit, while there was significant difference in potassium between the two groups on the operative day. Lactic acid level of the dead group was significantly higher than that of the survival group on the first day after the operation. Conclusion It is very important to monitor dynamic electrolytes, body fluid status and lactic acid concentration in the peri-operative period in order to ameliorate prognosis of the aged patients with critical disease.