关键词: 消化系统外科手术, 手术后并发症, 输注, 静脉内, 目标导向液体治疗, 晶体液, 胶体液

Abstract: Objective To evaluate the effects of crystalloid or colloid for intraoperative goal-directed fluid therapy on postoperative complications in patients undergoing gastrointestinal surgery. Methods Three hundred and sixty-two patients who were scheduled to receive open or laparoscopic gastrointestinal surgery under general anesthesia in our institution were enrolled. Patients were randomly divided into crystal solution group (n=180) and colloid solution group (n= 182). All patients had maintenance- lactated Ringer's solution administration throughout the operation period. The Vigileo/ FloTrac system was used to continuously monitor stroke volume (SV). In order to maximize SV, the two groups were treated for the goal-directed strategy. Intraoperative fluid infusion volume, blood loss, urine output and the administration of vasoactive agents were recorded. After surgery, postoperative morbidity and mortality within 30 days, hospital length of stay and hospital costs were followed. Results Numbers of bolus fluid infusion, total volume of fluid administered intraoperatively, net fluid balance, blood loss volume and the rate of norepinephrine administration were significantly lower in colloid solution group than those of crystal solution group, whereas urine output was higher in the colloid solution group (P＜0.05). There were no significant differences in the overall postoperative morbidity and mortality 30 days after operation between the two groups of patients (P＞0.05). There was a lower incidence of postoperative pneumonia 30 days after operation in the colloid solution group (P＜0.05). There were no significant differences in the length of hospital stay and hospital costs between the two groups (P＞0.05). Conclusion Compared with crystalloid, the intraoperative colloid-based goal-directed fluid therapy can reduce the intraoperative volume of fluid infusion and the incidence of postoperative pneumonia. However, it cannot reduce the overall postoperative morbidity or mortality.

Key words: digestive system surgical procedures, postoperative complications, infusions, intravenous, goal-directed fluid therapy, crystalloid, colloid