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The Effects of Intravenous Fluid Restriction on Hemorheology, Cardiac Troponin Ⅰ and S100B in Elderly Paitients Undergoing Intraabdominal Surgery

Author: PengZuoBao
Tutor: NiYuXia
School: Guangxi Medical University
Course: Anesthesiology
Keywords: Old people Laparotomy Restrictive transfusion Hemorheology Troponin I S100B
CLC: R656
Type: Master's thesis
Year: 2011
Downloads: 28
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Abstract

Objective To investigate the the restrictive transfusion hemorheology in patients with troponin I and serum S100B protein in elderly laparotomy, to provide the basis for the application of restrictive transfusion in elderly laparotomy. Methods to choose elective period laparotomy 60 patients over the age of 60, mainly for gastric cancer, colorectal cancer surgery patients, ASA Ⅰ - Ⅲ grade were randomly divided into 2 groups, each with 30 cases: (1) conventional infusion group ( Group S): In accordance with conventional rehydration Miller anesthesia academic programs rehydration: Enter the total amount of liquid (CVE) = compensatory expansion of the cumulative physical requirements missing volumes continued loss gap missing. (2) limit the infusion group (R): before induction of anesthesia into the abdomen about 60min to within complementary cumulative missing the amount of 1/2, after the infusion rate for 4ml/kg/h, every 15min measuring CVP CVP maintain 5 ~ 7cmH2O Without limiting the total infusion. Two sets of crystal, crystal colloidal ratio of 2:1, selection of Ringer's lactate, the the colloidal selection hydroxyethyl starch 130/0.4 Sodium Chloride Injection Voluven. Anesthesia full routine monitoring of ECG, BP, SpO2, CVP, urine output and input total amount of liquid. Both groups before anesthesia (T1), after extubation, intraoperative 2h (T2), 30min (T3), postoperative 24h (T4) extracted central venous detected in patients with hemorheology, troponin I and Serum S100B protein content. Postoperative complications after the patient returned to the ward and postoperative gastrointestinal recovery time and postoperative hospital stay. Results limit the total liquid input in the infusion group was significantly lower than conventional infusion group (P lt; 0.05); CVP in the restrictions infusion group was significantly lower than the the conventional infusion group (P lt; 0.05), but still within the normal range; restrictions infusion in group 2h and 30 min after extubation hemorheological parameters (whole blood, plasma viscosity and red blood cell hematocrit) significant changes (P lt; 0.05) compared with conventional infusion group, compared with the preoperative the same change significantly (P lt; 0.05). Limit h infusion in group troponin I S100B protein compared with conventional infusion group, no significant difference (P gt; 0.05), two sets of intraoperative, postoperative troponin the I S100B protein were not compared with the preoperative significant differences (P gt; 0.05). Restricted transfusion group compared with the conventional infusion group, fewer postoperative overall complication rate (P lt; 0.05); recovery time of gastrointestinal function earlier (P lt; 0.05); postoperative hospital stay was shorter (P lt; 0.05). Conclusion The elderly laparotomy the restrictive transfusion program of 4ml/kg/h is safe, feasible and able to maintain stable hemodynamics and hemorheology surgery, does not cause heart, brain hypoperfusion induced myocardial damage or brain damage, reduce postoperative complications and shorter postoperative hospital stay.

The Effects of Intravenous Fluid Restriction on Hemorheology, Cardiac Troponin Ⅰ and S100B in Elderly Paitients Undergoing Intraabdominal Surgery

Abstract

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