Changes Of Plasma Osmotic Pressure Of Peroperative Period In Patients With Colon Cancer

ObjectiveTo investigate the changes of plasma colloid osmotic pressure(COP) during peroperative period in patients with colon cancer.To find out the changes of COP during peri-bowel preparation period, infused crystal solutions before induction or in intraoperative period(colloidal fluid:crystal solution=1:1). Analyze on the tendency and correlations of the changes of COP.To find out the clinical directions of fluid replacement during preoperative reduce disorders of fluid balance.MethodsThere were 40 patients(ASA gradeⅠ-Ⅱ,with normal cardiovascular,lung,liver and renal function) undergoing radical colon cancer surgery, All patients preference in the preoperative bowel preparation with polyethylene glycol electrolyte powder 2L the day before operation. Infusion of crystal solution sodium lactate ringer's injection (LR) 10 ml/kg before induction,and maintain the same proportion for infusion of colloidal solution and crystal solution(voluven:LR=1:1,in turns) during intraoperative period.Infusing speed:1 h~500 ml.Blood samples were collected in follow time point:the morning of hospitalization(fasting 10 hs);in the operation room before open venous(after bowel preparation and 10 hs fasting);infused LR 10 ml/kg before induction;after induction; 500 ml voluven(~1h later);LR 500 ml(~2hs later);after extubation (~3hs later).subsequently determined the plasma colloid osmotic pressure and electrolytes (Na+,CL-) immediately.Record bleeding and urine volume.Choose spss 16.0 to handle all valuess, P< 0. 05 is regarded as the difference has statistical significance.ResultsThe plasma COP when patients in the operation room before open venous were higher than hospitalization (P<0.05);The values of COP after infused LR 10 ml/kg before induction were lower obviously than in the operation room before open venous (P<0.01);The values of COP after extubation were obviously lower than both hospitalization and in the operation room before open venous (P<0.01);The values of COP did not reach significant difference from the period of induction to extubation (P>0.05);the electrolytes did not reach significant difference from beginning still end of surgery (P>0.05).During the opetation,bleeding volume was120～180ml,urine volume was 150-200ml,Persistence time of opetation was 3 hours.Conclution1 Bowel preparation before undergoing radical resection of colon cancer raised the plasma COP obviously among normal range;it seems caused by the patients losing plenty of water contents to induce pachernia.2 In order to supply physiological needs,infuse plenty of crystal solutions induced hemodilution and results in the values of COP decreased obviously before induction.3 Maintain the same proportions for infusion of colloidal fluid and crystal solution(voluven:LR=1:l,in turns) during intraoperative period can hold COP and internal environment homeostasis.It is recommended.4 The values of COP were decreased prominently after operation due to the hemodilution during operation procedure.5 the crystal osmotic pressure remain unchanged.It maybe results in bowel preparation with polyethylene glycol electrolyte powder.