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[目的]探讨高龄胃癌患者胃癌根治术后液体治疗的合理优化方案.[方法]将老年胃癌患者分为治疗组及对照组,两组均行标准D2手术,治疗组术后第1,2,3d加用60g/L羟乙基淀粉130/0.4氯化纳注射液(60g/L HES)20mL/(kg·d),对照组术后给予等量液体(葡萄糖氯化钠注射液),其余治疗均相同.观察两组患者术后1,2,3d液体量,心率、中心静脉压及平均动脉搏压的变化;比较自主排气恢复时间、进全流食时间及平均住院时间.[结果]治疗组自主排气恢复时间为(2.8±1.4)d,对照组为(3.5±1.5)d,相比较差异具有统计学意义(P<0.05);治疗组术后进全流食时间及平均住院时间均明显短于对照组(P<0.05).[结论]60g/L羟乙基淀粉130/0.4氯化纳注射液补液优于单纯晶体补液,为今后高龄胃癌患者D2术后液体正确输入提供了优化的补液方案.
[Objective] To explore the rational optimization of liquid therapy for gastric cancer patients with advanced gastric cancer undergoing radical operation. [Methods] The patients with advanced gastric cancer were divided into treatment group and control group. Both groups underwent standard D2 surgery. 3d plus 60g / L hydroxyethyl starch 130 / 0.4 sodium chloride injection (60g / L HES) 20mL / (kg · d), the control group was given an equal amount of liquid (glucose and sodium chloride injection), the rest The changes of fluid volume, heart rate, central venous pressure and mean arterial pressure during the first, second and third day after operation were observed, and the time of spontaneous exhaust recovery, the time of full flow of food and the average length of hospital stay were compared. [Results] The recovery time of spontaneous exsanguination in the treatment group was (2.8 ± 1.4) days, and in the control group was (3.5 ± 1.5) days, the difference was statistically significant (P <0.05). The total flow time and average length of hospital stay (P <0.05). [Conclusion] 60g / L hydroxyethyl starch 130 / 0.4 sodium chloride injection is better than pure crystal rehydration in order to provide the correct fluid for D2 patients after advanced gastric cancer Optimized rehydration solution.