CAJ | 학술논문

目的探讨消化系统恶性肿瘤根治术患者术后实施早期目标导向治疗(EGDT)的效果.方法择期消化系统恶性肿瘤根治术患者186例,麻醉恢复后立即转入ICU,随机分为2组:对照组(n=89)和EGDT组(n=97),对照组术后常规补液(晶体和胶体)治疗,EGDT组术后8 h内行EGDT,即在CVP、MAP、中心静脉血氧饱和度及尿量的指导下,进行滴定式液体(晶体和胶体)治疗及应用血管活性药物.监测术后24 h内心脏指数(CI)及氧供指数(DO2I),记录术后感染发生情况.结果与对照组比较,EGDT组术后8 h和24 h CI和DO2I明显升高,ICU住院时间缩短,术后感染的发生率降低(P＜0.05或0.01).结论消化系统恶性肿瘤根治术后行EGDT有助于患者的术后恢复.
목적 탐토소화계통악성종류근치술환자술후실시조기목표도향치료(EGDT)적효과.방법 택기소화계통악성종류근치술환자186례,마취회복후립즉전입ICU,수궤분위2조:대조조(n=89)화EGDT조(n=97),대조조술후상규보액(정체화효체)치료,EGDT조술후8 h내행EGDT,즉재CVP、MAP、중심정맥혈양포화도급뇨량적지도하,진행적정식액체(정체화효체)치료급응용혈관활성약물.감측술후24 h내심장지수(CI)급양공지수(DO2I),기록술후감염발생정황.결과 여대조조비교,EGDT조술후8 h화24 h CI화DO2I명현승고,ICU주원시간축단,술후감염적발생솔강저(P＜0.05혹0.01).결론 소화계통악성종류근치술후행EGDT유조우환자적술후회복.
Objective To investigate the efficiency of early goal-directed therapy(EGDT)on the hemodynamics,the incidence of postoperative infectious complications and duration of ICU stay after the digestive system tumor radical operation.Methods One hundred and eighty-six patients after digestive system tumor radical operation in intensive care unit(ICU),both sexes,aged 55 to 75 yr,were randomized into control group(n=89)and EGDT group(n=97).The control group received conventional fluid therapy,and the colloid and crystal solution were infused to maintain SpO2＞94%,Hb 80-150 g/L,HR 60-100 bpm,MAP 100-150 mm Hg.The EGDT group received the vasoactive agents combined with conventional fluid therapy to maitain CVP 8-12 cm H2O,MAP with the control group,CI and DO2I weve significantly increased,the duration of ICU stay and the incidence of postoperative infectious complications were reduced significantly in EGDT group.Conclusion EGDT can be helpful greatly for the patients recovery after digestive system tumor radical operation.