The Influence Of Two Kinds Of Fluid Therapy Measure On The Postoperative Outcome In Fast Track Of Colon Cancer

Objective: To compare the influence of two different Fluid Therapy Measure on the clinical efficacy of patients with colorectal carcinoma during the fast-track surgery.Materials and Methods: Patients that were diagnosed with colorectal carcinoma by the First Hospital of Jilin University during November 2015 and December 2016 and were scheduled to undergo the laparoscopic surgery were prospectively included and divided into the experimental group and the control group with the random number method.After surgery,patients in the experiment group were provided with intravenous fluid administration at 1.0ml/(kg·h)(The 'h' is just on behalf of the expected time of intravenous fluids)and encouraged to take food and drink water early after surgery,and the intravenous fluid administration was stopped immediately when the oral intake was more than 1500ml/h;patients in the control group strictly followed the fasting and were provided with the intravenous fluid administration at 2.0ml/(kg·h)until their intestinal function completely recovered.The blood volume change indicators(heart rate,mean arterial pressure,oxyhemoglobin saturation,inferior vena cava diameter/body surface area(VCD),intra-abdominal pressure(IAP),specific gravity of urine,BNP,etc)and inflammation indicators(CRP,IL-6,TNF-?)of the two groups of patients were observed and a comparison was made of the recovery time of intestinal function,incidence of complications,hospitalization time after operation and hospitalization expenses of the two groups.Results: The study finally included 146 patients(69 patients in the experimental group and 77 patients in the control group).The blood volume changes and inflammation indicator differences of the two groups on admission had no statistical significance(for both groups,P>0.05).After surgery,the heart rate,mean arterial pressure and oxyhemoglobin saturation of the experimental group had no statistical difference from the control group(P>0.05),but there were great differences between the two groups in VCD,IAP,specific gravity of urine,BNP,CRP,IL-6 and TNF-?(P<0.05).Compared with the control group,the experimental group patients' recovery time of intestinal function [(2.3±1.0)d vs.(2.9±1.3)d,P=0.025],hospitalization time after operation [(6.7±2.0)d vs.(8.8±2.6)d,P=0.038] and hospitalization expenses [(52749±9644)RMB vs.(59942±11217)RMB,P=0.027] were obviously lower.Besides,the experimental group's incidence of complications was also evidently lower than the control group(P<0.05).Conclusion: During the fast-track surgery procedures of the patients with colorectal carcinoma,the restrictive fluid administration could effectively reduce the fluid load and reduce inflammation and stress response,facilitate the recovery of their gastroenteric functions and was conducive to the decrease of complications,shortening of hospitalization time and lowering of hospitalization expenses.During the fast-track surgery procedures of the patients with colorectal carcinoma,the program that the volume of postoperative venous fluid calculated according to 1.0ml/(kg·h)and combined with early oral rehydration is safety,can be applied to clinical.Compared with the traditional liquid therapy regimen,the restricted regimen can reduce the capacity load,reduce perioperative stress,reduce the inflammatory response;it can also effectively reduce the complications,shorten the hospital stay and save the hospital costs.