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晶体液输注与小儿择期 Roux-en-Y 肝空肠吻合术的恢复相关。

Crystalloid Administration Is Associated with the Recovery of Pediatric Elective Roux-en-Y Hepaticojejunostomy.

作者信息

Tan Xingqin, Liu Jianxia, Guo Chunbao

机构信息

Department of Anesthesiology, Children's Hospital, Chongqing Medical University, Chongqing, China.

Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital, Chongqing Medical University, Chongqing, China.

出版信息

Eur J Pediatr Surg. 2020 Apr;30(2):187-192. doi: 10.1055/s-0038-1677544. Epub 2019 Jan 21.

Abstract

INTRODUCTION

Intraoperative fluid administration is important for postoperative recovery and might be associated with postoperative complications.

MATERIALS AND METHODS

This retrospective review included 471 patients who underwent Roux-en-Y hepaticojejunostomy. Patients were separated into two groups based on whether they received low (<15.27 mL/kg/h) or high (>15.27 mL/kg/h) volumes of corrected crystalloid fluids. Propensity score matching was performed to adjust for any potential selection bios for the two groups. In 192 matched patients, clinical outcomes, including postoperative complications and length of hospital stay, were compared.

RESULTS

Higher use of diuresis ( = 0.027) was found in the high fluid group. Receiving low volumes of crystalloids was associated with postoperative gastrointestinal functional recovery, reflected by the first defecation (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.31-1.07;  = 0.047) and first bowel movement (OR, 0.56; 95% CI, 0.38-0.98;  = 0.013). However, the occurrence of renal complications did not show significant differences between the groups. A lower postoperative complication rate (OR, 0.54; 95% CI, 0.42-0.94;  = 0.016) was noted in patients with low crystalloids compared with high crystalloids. The total length of hospital stay was longer in patients with high crystalloid fluid (9.21 ± 3.24 days) than patients with low volumes (7.83 ± 2.58 days;  = 0.012).

CONCLUSION

Low crystalloid fluid administration was associated with favorable postoperative outcomes.

摘要

引言

术中液体输注对术后恢复很重要,且可能与术后并发症相关。

材料与方法

本回顾性研究纳入了471例行Roux-en-Y肝空肠吻合术的患者。根据患者接受的校正晶体液量低(<15.27 mL/kg/h)或高(>15.27 mL/kg/h)将其分为两组。进行倾向评分匹配以调整两组间任何潜在的选择偏倚。对192例匹配患者的临床结局进行比较,包括术后并发症和住院时间。

结果

高液体量组发现更高的利尿使用率(P = 0.027)。接受低量晶体液与术后胃肠功能恢复相关,表现为首次排便(比值比[OR],0.69;95%置信区间[CI],0.31 - 1.07;P = 0.047)和首次肠蠕动(OR,0.56;9%CI,0.38 - 0.98;P = 0.013)。然而,两组间肾脏并发症的发生率无显著差异。与高晶体液组相比,低晶体液组患者术后并发症发生率更低(OR,0.54;95%CI,0.42 - 0.94;P = 0.016)。高晶体液量患者的总住院时间(9.21±3.24天)比低量患者(7.83±2.58天;P = 0.012)更长。

结论

低晶体液输注与良好的术后结局相关。

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