Zausig Y A, Weigand M A, Graf B M
ZARI - Zentrum Anaesthesiologie, Rettungs- und Intensivmedizin, Universitätsklinikum, Georg-August-Universität, Göttingen, Germany.
Anaesthesist. 2006 Apr;55(4):371-90. doi: 10.1007/s00101-006-0988-5.
Optimal perioperative fluid management is still controversial. Besides well known perioperative hypovolaemia, hypervolaemia has an influence on perioperative morbidity and mortality, particularly with regard to the patient's medical history, a reduced cardiac and pulmonal function and the operation itself. The concepts of preoperative, intraoperative and postoperative fluid administration are neither adequately validated, nor sufficiently integrated into a perioperative concept. At the present, moderate fluid administration to improve preoperative and postoperative outcome is safe in minor or medium surgical procedures. High-risk surgical patients benefit from a time-oriented or/and goal-oriented monitored fluid therapy. In the past only little attention has been concentrated on postoperative fluid management, but may be stimulated by the new concepts of fast track surgery.
最佳围手术期液体管理仍存在争议。除了众所周知的围手术期低血容量外，高血容量也会影响围手术期的发病率和死亡率，尤其是考虑到患者的病史、心脏和肺功能减退以及手术本身。术前、术中和术后液体管理的概念既未得到充分验证，也未充分纳入围手术期概念中。目前，在小型或中型外科手术中，适度补液以改善术前和术后结果是安全的。高危手术患者受益于定时或/和目标导向的监测液体治疗。过去，人们很少关注术后液体管理，但快速康复外科的新概念可能会促使这一情况得到改善。
