Pcv-aCO2联合ScvO2指导胃癌术后补液的意义

王惠君1 ，王沙2 *，乔莉娜1 ，高向楠1

（1.西安交通大学第一附属医院普通外科，陕西 西安，710061；2. 陕西省人民医院心脏外科，陕西 西安，710061）

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摘要：

目的 探讨ScvO2 和Pcv-aCO2 对胃癌术后患者补液的指导意义。方法 选取在我科行手术治疗的100 例胃癌患者，随机 分为试验组和对照组，各50 例。试验组术后3 d 常规抽取中心静脉及动脉血血气获取ScvO2 及Pcv-aCO2 值，对照组不做特 殊处理。比较两组患者术后3 d 补液量、输液相关的术后并发症。结果 试验组术后3 d 的补液量明显少于对照组，术后输液 相关的并发症发生率明显低于对照组（P<0.05）。结论 ScvO2 及Pcv-aCO2 对指导胃癌术后患者补液有一定意义。

关键词：ScvO2；Pcv-aCO2；胃癌；术后补液

中图分类号：R459.7文献标志码：A文章编号：2096-1413(2018)03-0101-02

Significance of Pcv-aCO2 and ScvO2 in guiding fluid rehydration after gastric carcinoma operation
WANG Hui-jun 1, WANG Sha2 *, QIAO Li-na1, Gao Xiang-nan 1
(1. General Surgery Department, the First Affiliated Hospital of Xi``an Jiaotong University, Xi``an 710061; 2. Cardiac Surgery Department, Shaanxi Provincial People``s Hospital, Xi``an 710061, China)

ABSTRACT: Objective To explore the significance of ScvO2 and Pcv-aCO2 in guiding fluid rehydration after gastric carcinoma operation. Methods One hundred patients with gastric cancer undergoing operation in our department were selected and randomly divided into experimental group (50 cases) and control group (50 cases). The ScvO2 and Pcv-aCO2 values in the experimental group were obtained by extracting central venous and arterial blood gas at 3 d after operation. The control group was not treated specially. The volume of fluid rehydration in 3 d after operation and postoperative complications associated with transfusion were compared between the two groups. Results The volume of fluid rehydration in 3 d after operation in the experimental group was significantly less than that in the control group, the incidence rate of postoperative complications associated with transfusion was significantly lower than that in the control group (P<0.05). Conclusion The ScvO2 and Pcv-aCO2 values have significance to guide the fluid rehydration after gastric cancer operation.
KEYWORDS: ScvO2; Pcv-aCO2; gastric cancer; fluid rehydration after surgery

参考文献：
[1] DELLINGER RP,LEVY MM,CARLET JM,et al.Surviving sepsis campaign:internationgal guidelines for management of severe sepsis and
septic shock:2008[J].Intensive Care Med,2008(34):17-60.
[2] KADOI Y,SAITO S,GOTO F,et al.The effect of diabetes on the interrelationship between jugular venous oxygen saturation responsiveness to phenylephrine infusion and cerebrovascular carbon dioxide reactivity[J].Anesth Analg,2004,99(2):325-331.
[3] POPE JV,JONES AE,GAIESKI DF,et al.Multicenter study of central venous oxygen saturation [ScvO2] as a predictor of mortality in patients with sepsis[J].Ann Emerg Med,2010,55(1):40-46.
[4] FUTIER E,ROBIN E,JABAUDON M,et al.Central venous O2 saturation and venous-to -arterial CO2 difference as complementary tools for goal-directed therapy during high-risk surgery[J].Crit Care,2010 (14):R193.
[5] VON HEYMANN C,GREBE D,SCHWENK W,et al.The influence of intraoperative fluid therapy on the postoperative outcome in "fast track" colon surgery [J].Anasthesiol Intensivmed Notfallmed Schmerzther, 2006,41(6):E1-E7.
[6] RAHBARI NN,ZIMMERMANN JB,SCHMIDT T,et al.Meta-analysis of standard, restrictive and supplemental fluid administration in colorectal surgery[J].Br J Surg,2009,96(4):331-341.