The Research On The Application Of Postoperative And Fluid Restriction Administration For Open Abdominal Surgery

Objective There is a long-standing controversy about the fluid therapy.The concepts of fluid management have been developed in the past decades.At present great volume of fiuid is administered to maintain an effective circulating volume, and to prevent inadequate tissue perfusion.It'shown that the administration of large-volume of fluid is associated with postoperative complications, and moderate limit of liquid intake can improves the outcomes in the surgery.Restrictive fluid therapy has become a branch of Fast Track Surgery, but its mechanism has not been fully elucidated. In recent years,a number of domestic and international preliminary clinical study showed that patients applied restrictive fluid therapy can not only promote the emergence of negative balance, reduce ventilation time, but also can reduce postoperative complications and hospitalization costs.However,there is still much controversy, and its mechanisms remain unclear. In this study,66 patients with open abdominal surgery were taken to investigate the object.The purpose of the study is to provide a reference for clinical transfusion, to provide a theoretical basis for Fast Track Surgery,and to investigate the effectiveness and safety of using intravenous fluid restriction in patient undergoing open intraabdominal surgery.Methods 66 cases of ASA I or III patients (36 males,30 females) aged 45-89yr weighing 47-80 kg of general surgery in our hospital undergoing open abdominal surgery, they were selected to pairs according to the same hospitalization and operation period and randomly divided into two groups.Trial group (n=33)were treated with restrictive fluid therapy,control group(n=33) were treated with general fluid. Operation time, total intraoperative intravenous infusion, blood loss, blood transfusions, urine output, and the surgical procedure,and the quantity and sort of the liquid in postoperative three days were recorded.Overcomes were assessed by mechanical ventilation time,length of hospital and postoperative complications.Results1. Compared to control group,trial group were not significantly different in age, weight, sex ratio, ASA classification percentage, and the type of operation, intraoperative fluid infusion and other aspects (P>0.05).2. Compared to control group,trial group have less urine in postoperativeⅠⅡdays (P<0.05)3. The ventilation time of trial group is 63.0±28 hours, control group is 90±41 hours, control group's ventilation time is significantly longer than trial group's (P< 0.05)4.Compared to control group,trial group have shorter postoperative hospital stay. (P<0.05)5. Compared with the control group, trial group has lower incidence of wound healing, anastomotic fistula, pulmonary infection (P< 0.05),but no significant difference in other postoperative complications,such as arrhythmia, nausea and vomiting, diarrhea,urinary tract infections and mortality statistics(P>0.05).Conclusion1. The clinical use of intravenous fluid restriction therapy in patient undergoing open abdominal surgery can reduce the incidence of wound healing, anastomotic fistula, pulmonary infection,and improve the prognosis of patients.2. The clinical use of intravenous fluid restriction therapy in patient undergoing open abdominal surgery can reduce ventilation time, shorter postoperative hospital stay.lt is an safe and effective way.