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限制性输液在腹部外科的应用

Journal of General Surgery for Clinicians (Electronic Version)(2014)

Cited 3|Views6
Abstract
许多外科手术,可导致全身炎症反应综合征,引起全身性毛细血管系统渗漏综合征。除了局部的水肿和渗出以外,全身毛细血管通透性增加,血管内液体和血浆蛋白质渗漏至组织间隙,表现为低血容量、低蛋白血症和全身水肿。其结果可进一步导致生命器官及微循环的低血流灌注状态。这种病理状态可致术野局部微循环灌注量减少16%,发生吻合口瘘者的局部血流量减少则更为显著。限制性液体治疗其基本做法是限制术后水、钠的输入,晶体液只用维持量使尿量不少于0.5ml/(kg·h),应用人工胶体溶液补充循环血量,保持机体整体血流动力学稳定。
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