摘要
目的 探讨消化道穿孔 (DTP)急诊手术病例围手术期液体正平衡与APACHEⅡ评分的关系。方法 根据APACHEⅡ评分 ,将连续 3 72例DTP病例分为轻症 ( <8分 )、重症 ( 8-19分 )和危重病例 (≥ 2 0分 )三组 ,比较三组病例手术前、手术日和术后第 1日的液体正平衡量。结果 轻症、重症和危重病例术前的液体正平衡量分别为 112 6.91± 414 .80ml、2 3 60 .89± 85 7.0 3ml和 3 494.97± 995 .65ml(P <0 .0 1) ;手术日液体正平衡量分别为 2 10 3 .71± 72 8.99ml、40 5 0 .5 6± 10 3 6.3 7ml和 5 743 .95±12 5 6.2 1ml(P <0 .0 1) ;术后第 1日液体正平衡量分别为 916.81± 5 5 9.62ml、12 11.43± 679.85ml和15 87.0 9± 73 3 .3 8ml(P <0 .0 1)。结论 无论是术前、手术当日或术后第 1日 ,DTP病例的液体正平衡量与其APACHEⅡ评分正相关。APACHEⅡ评分可估测DTP病例的液体正平衡量 ,指导其围手术期的液体治疗。
Objective To evaluate the relationship between perioperative positive fluid balance and APACHEⅡ score of the patients undergoing emergent laparotomy with digestive tract perforation. Methods According to APACHEⅡ score on admission, 372 patients with digestive tract perforation were divided into three groups: mild group (the score<8), severe group (the score 8-19) and critical group (the score≥20). The volumes of perioperative positive fluid balance were compared among three groups. Results The volume of positive fluid balance of mild, severe and critical cases was 1126.91±414.80 ml, 2360.89±857.03 ml and 3494.97±995.65 ml (P<0.01) respectively during preoperative phase, was 2103.71±728.99 ml, 4050.56±1036.37 ml and 5743.95±1256.21 ml (P<0.01) respectively on operative day, was respectively 916.81±559.62 ml, 1211.43±679.85 ml and 1587.09±733.38 ml (P<0.01) in the first day after emergent laparotomy. Conclusions There was significant positive correlation between the volume of perioperative positive fluid balance and APACHE Ⅱ score of patients with digestive tract perforation. APACHEⅡ score could predict the volume of perioperative positive fluid balance and direct fluid therapy in patients with digestive tract perforation.
出处
《消化外科》
CSCD
2003年第4期257-259,共3页
Journal of Digestive Surgery
关键词
消化道穿孔
液体治疗
正平衡
手术
评分
digestive tract perforation fluid therapy positive fluid balance operation scoring
