Effects Of Three Different Kinds Of Fluid Therapies On Intraoperative Circulatory State,Inflammatory Factors And Postoperative Early Recovery In Patients Undergoing Laparoscopic Colorectal Surgery

Objective : To compare the differences between goal-directed fluid therapy,the traditional fluid therapy and the restrictive fluid therapy on intraoperative circulatory state,inflammatory factors and postoperative recovery in patients undergoing Laparoscopic colorectal surgery to explore the best fluid treatment for intestinal surgery.Methods : A total of 60 volunteers underwent laparoscopic colorectal resection at Shengjing Hospital affiliated to China Medical University were chosen from April2018 to October 2018.The volunteers were randomly divided into 3 groups by lottery : G group ? T group and R group).The patients were interviewed before operation,and the basic information of the patients was collected.During the operation,one of the three different liquid treatment options was used to replenish the blood volume,and the routine monitoring methods such as blood pressure and blood oxygen saturation were dynamically monitored,blood gas analysis was performed,and hemodynamic parameters were recorded.IL-6?TNF-?and CRP in arterial blood of the patients were measured before surgery and when leaving the PACU.Patients were interviewed after surgery,we collected the patient's postoperative results including the first drinking time,the first eating time,the first exhaust time,the first defecation time and complications.Indicators of intraoperative blood pressure,heart rate,the difference of postoperative recovery time and so on were compared between the three groups.Results:1.There was no significant difference in the preoperative status between the three groups(P>0.05).The systolic blood pressure at one hour from the beginning of surgery was statistically significant between the G group and the R group(P<0.05).2.The goal-directed and traditional fluid therapy group had less postoperative hospital stay compared with the restrictive fluid therapy group(P<0.05).3.The restrictive fluid therapy group had a higher increase of IL-6 and TNF-? compared with the goal-directed and traditional fluid therapy group.4.The concentration of albumin was significantly lower than that before surgery(P<0.05),and the mean difference was9.148.3±3.2458 g/L.But there was no significant difference in the degree of reduction between the three groups(P>0.05).5.Several mild complications occurred in patients of each group after surgery and returned to normal before discharge.Conclusion:The three fluid therapies are all safety to use in clinical.Goal-directed fluid therapy can maintain the stability of the patient's circulatory status than restrictive fluid therapy during surgery.Compared with the restrictive fluid therapy group in the trial,goal-directed fluid therapy and traditional fluid therapy were able to reduce the length of postoperative hospital stay.Compared with the restrictive fluid therapy group in the trial,goal-directed fluid therapy and traditional fluid therapy had Less increase on the concentrate of IL-6 and TNF-? in blood.