CAJ | 학술논문

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.
목적 조사경진삼가삼급갑등의원보외과술후환자액체치료현상. 방법 회고성조사접수보외과수술적주원차술후금식3 d이상적환자600례,불한년령화성별、소환질병충류화접수적수술류형.통계지표포괄환자적일반자료、수술전후실험실검사、술후3 d액체치료내용화부분림상지표(술후병발증、수액반응등). 결과 588례유효병례술후매천평균보액총량위(3030±638)ml;평균매천급여포도당(142±67)g、록화갑(59.9±23.9)mmol、록화납(179.5±66.7)mmol;85.2%적환자접수영양지지,장외영양여장내영양비위28:1;술전체질지수(BMI)≥18.5 kg/m2적환자유549례,기중접수장외영양화장내영양지지공유470례(85.6%);BMI<18.5 kg/m2공39례,급여규범적장외영양지지27례(69.2%).균미급여장내영양.술후3 d액체치료중미급여록화갑36례차. 결론 경진삼급갑등의원보외과술후환자접수영양지지화장외영양적비례균과고;즉용형복합당전해질제제가감소차착화유익우대다수술후환자.
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.