Effects Of Goal-directed Fluid Therapy On The Intestinal Blocking Of The Elderly Patients With Colon Cancer Surgery

Objectives To observe the effects on intestinal barrier of colon cancer surgery with elderly patients by using fluid therapy guided by SVV and conventional fluid therapy guided by CVP respectively.Methods 50 elderly patients with ASA Ⅱ-Ⅲ level were randomly divided into Group S with 25 cases(fluid therapy guided by SVV)and Group C with 25 cases(conventional fluid therapy). Group S was treated with goal-directed fluid infusion at the maximum of 10%≤SVV≤12%, while Group C was treated with conventional infusion characterized by monitoring central venous pressure(8≤CVP≤12cm H2O), mean arterial pressure(MAP60-100 mm Hg) and urine volume(≧1ml/h/kg). Fluid volume, surgery time, urine volume, blood loss, exhausting time, post-operative hospitalization days in Group S and Group C were recorded. And MAP, HR, CVP, SVV, HCO3ˉ of patients were recorded at the same time before anesthesia(T0), beginning of surgery(T1), one hour after surgery(T2) and ending of surgery(T3) respectively. Venous bleed in patients were extracted at the period of T0, T1, T2 and T3 to detect the content of DAO and D-lactic acid respectively.Results The dynamics of blood flow in both groups MAP comparison, T2-3 point C was higher than group S(P<0.001), the difference was statistically significant. Comparison of heart rate and carbonic acid between the two groups, the difference was not statistically significant(P> 0.05). The CVP comparison, T2-3 point group C was higher than group S(P <0.001), the difference was statistically significant. The SVV comparison, T2-3 point group C was higher than group S(P <0.001), the difference was statistically significant. Crystalloid, colloid and the total infusion group S were lower than group C, the difference was statistically significant(P<0.05); The DAO in both group in T2-T3 point are higher than T0 point, the difference was statistically significant(P <0.001). S group increased compared with C group is small, the difference was statistically significant(P <0.001). The D- lactic acid in both group in T2-T3 point are higher than T0 point, the difference was statistically significant(P <0.001). The group S increasingly is smaller than group C, the difference was statistically significant(P <0.001).Conclusions(1) Goal-directed fluid therapy used in cancer surgery patients, can be achieved with less applied liquid maintain hemodynamic stability, and ensure intestinal blood perfusion, microcirculation.(2) Goal-directed fluid therapy for patients with colon cancer intestinal barrier has a protective effect.