术中液体治疗对剖宫产患者术后并发症影响的前瞻性对照研究1敖翔.docVIP

术中液体治疗对剖宫产患者术后并发症影响的前瞻性对照研究 敖翔，孙龙，胡宝吉，段宏伟，唐卫青* 上海市浦东医院，复旦大学附属浦东医院麻醉科，上海 201399 [摘要]目的：比较剖宫产术中液体量、液体种类对患者术后0.05）；XR和XH组较KH组术后24h出血量显著减少（P0.05），同时XH和KH组较XR、KR两组术后首次排气时间明显缩短（P0.05）。结论：剖宫产术中予限制性胶体治疗可促进患者术后胃肠功能恢复，不增加术后出血量，可作为剖宫产手术的合理液体治疗方案。 [关键词]剖宫产；液体治疗；产后出血；产后感染；肠梗阻 Effects of different fluid therapies on postoperative complications of cesarean section: a randomized clinical trail AO Xiang, SUN Long, HU Bao-ji,DUAN Hong-wei, TANG Wei-qing* Department of Anesthesia, shanghai Pudong Hospital, Fudan University Pudong Medical Center, 2800 Gongwei Road, Pudong, Shanghai 201399, China； [Abstract]Objective: To compare the effects of liquid volume and liquid type on the postoperative complications of cesarean section. Methods: 320 patients undergoing cesarean sectionwere randomly divided into XR, XH, KR and KH four groups, accepting restrictive crystals of 10mg/kg, restrictive colloids of 10mg/kg, open crystals of 20mg/kg and open colloids of 20mg/kg, respectively.The incidence of postpartum hemorrhage, postpartum infection and intestinal obstruction were followed up. The postoperativehemorrhage volume within 24 hours and the first time to flatus after surgery were recorded as well. Results: There was no significant difference in the incidence of postpartum hemorrhage, postpartum infection and intestinal obstruction among the four groups（P0.05）;The postoperativehemorrhage volume within 24 hours in group XR and group XH were significantly decreased compared with group KH（P0.05）; Group XH and group KH had markedly shorter time to first flatus after surgery compared to group XR and group KR（P0.05）. Conclusions:The treatment with limited colloid in cesarean section can promote postoperative gastrointestinal function recovery and reduce the amount ofpostoperative bleeding, and may be used as a reasonable liquid treatment programfor cesarean section. [Keywords] Cesarean section; fluid therapy; postpartum hemorrhage; postpartum infection; intestinal obstruction 剖宫产术后存在诸多并发症，包括近期产后