10张高清PPT,详解围术期补液原则!

2021-11-27 徐医附院麻醉科 徐医附院麻醉科

尽量减少术前禁食时间,减少患者在入室前的体液丢失。

外科手术患者常因各种术前准备使液体摄人减少和(或)丢失增加。同时,手术创伤等导致的失血、引流液的丢失以及炎症细胞活化、炎症介质大量释放,循环中的中性粒细胞等与血管壁内皮细胞相互作用使得毛细血管通透性增加,均能导致血容量丢失。此外,麻醉引起的容量血管扩张则更加剧了有效循环容量的不足。

因此,围术期需采取适当的液体治疗策略以维持机体有效循环容量、满足组织灌注和细胞氧供。

图片

图片

图片

图片

图片

图片

图片

图片

图片

图片

图片

图片

图片

图片

图片

图片

图片

图片

图片

尽量减少术前禁食时间,减少患者在入室前的体液丢失。
在使用零平衡液体治疗策略时,许多围手术期医生会过于限制补液,应该推荐在手术结束时达到液体正平衡 1~2 L 的适度开放性补液方案。
由于腹部手术,患者常无法迅速过渡到经口完全补液,建议在术后采用 1.5 mL/(kg·h) 的剂量继续输液至少 24 小时。
当然,面对如高龄或存在心脏功能疾病的某些特殊患者,采用一些便于监测的指标,CVP、血压、心率、呼吸以及被动抬腿试验(或补液试验)指导术后补液可能是更合理的选择。

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1947535, encodeId=a096194e53507, content=<a href='/topic/show?id=360f14591e2' target=_blank style='color:#2F92EE;'>#PPT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14591, encryptionId=360f14591e2, topicName=PPT)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/78FA0899509C358B01B975E8EAC1F88A/100, createdBy=7d822500145, createdName=ms5353107019656438, createdTime=Sat Jul 02 10:32:55 CST 2022, time=2022-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1275470, encodeId=d85e12e54705a, content=<a href='/topic/show?id=6a39406551e' target=_blank style='color:#2F92EE;'>#围术期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40655, encryptionId=6a39406551e, topicName=围术期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5fca128, createdName=licz0423, createdTime=Mon Nov 29 09:32:55 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074697, encodeId=c2e310e46971b, content=型肝炎的治疗方法因直接作用抗病毒, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sun Nov 28 07:46:29 CST 2021, time=2021-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074613, encodeId=f86510e461318, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220625/6f4f075937de4c5d9fc7ab3a1bc6d8c2/13a8a29e67044698af1fb74276589093.jpg, createdBy=b5c55099112, createdName=D-House, createdTime=Sat Nov 27 21:04:51 CST 2021, time=2021-11-27, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1947535, encodeId=a096194e53507, content=<a href='/topic/show?id=360f14591e2' target=_blank style='color:#2F92EE;'>#PPT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14591, encryptionId=360f14591e2, topicName=PPT)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/78FA0899509C358B01B975E8EAC1F88A/100, createdBy=7d822500145, createdName=ms5353107019656438, createdTime=Sat Jul 02 10:32:55 CST 2022, time=2022-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1275470, encodeId=d85e12e54705a, content=<a href='/topic/show?id=6a39406551e' target=_blank style='color:#2F92EE;'>#围术期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40655, encryptionId=6a39406551e, topicName=围术期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5fca128, createdName=licz0423, createdTime=Mon Nov 29 09:32:55 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074697, encodeId=c2e310e46971b, content=型肝炎的治疗方法因直接作用抗病毒, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sun Nov 28 07:46:29 CST 2021, time=2021-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074613, encodeId=f86510e461318, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220625/6f4f075937de4c5d9fc7ab3a1bc6d8c2/13a8a29e67044698af1fb74276589093.jpg, createdBy=b5c55099112, createdName=D-House, createdTime=Sat Nov 27 21:04:51 CST 2021, time=2021-11-27, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1947535, encodeId=a096194e53507, content=<a href='/topic/show?id=360f14591e2' target=_blank style='color:#2F92EE;'>#PPT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14591, encryptionId=360f14591e2, topicName=PPT)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/78FA0899509C358B01B975E8EAC1F88A/100, createdBy=7d822500145, createdName=ms5353107019656438, createdTime=Sat Jul 02 10:32:55 CST 2022, time=2022-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1275470, encodeId=d85e12e54705a, content=<a href='/topic/show?id=6a39406551e' target=_blank style='color:#2F92EE;'>#围术期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40655, encryptionId=6a39406551e, topicName=围术期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5fca128, createdName=licz0423, createdTime=Mon Nov 29 09:32:55 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074697, encodeId=c2e310e46971b, content=型肝炎的治疗方法因直接作用抗病毒, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sun Nov 28 07:46:29 CST 2021, time=2021-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074613, encodeId=f86510e461318, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220625/6f4f075937de4c5d9fc7ab3a1bc6d8c2/13a8a29e67044698af1fb74276589093.jpg, createdBy=b5c55099112, createdName=D-House, createdTime=Sat Nov 27 21:04:51 CST 2021, time=2021-11-27, status=1, ipAttribution=)]
    2021-11-28 查查佳佳

    型肝炎的治疗方法因直接作用抗病毒

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1947535, encodeId=a096194e53507, content=<a href='/topic/show?id=360f14591e2' target=_blank style='color:#2F92EE;'>#PPT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14591, encryptionId=360f14591e2, topicName=PPT)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/78FA0899509C358B01B975E8EAC1F88A/100, createdBy=7d822500145, createdName=ms5353107019656438, createdTime=Sat Jul 02 10:32:55 CST 2022, time=2022-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1275470, encodeId=d85e12e54705a, content=<a href='/topic/show?id=6a39406551e' target=_blank style='color:#2F92EE;'>#围术期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40655, encryptionId=6a39406551e, topicName=围术期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5fca128, createdName=licz0423, createdTime=Mon Nov 29 09:32:55 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074697, encodeId=c2e310e46971b, content=型肝炎的治疗方法因直接作用抗病毒, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sun Nov 28 07:46:29 CST 2021, time=2021-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074613, encodeId=f86510e461318, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220625/6f4f075937de4c5d9fc7ab3a1bc6d8c2/13a8a29e67044698af1fb74276589093.jpg, createdBy=b5c55099112, createdName=D-House, createdTime=Sat Nov 27 21:04:51 CST 2021, time=2021-11-27, status=1, ipAttribution=)]
    2021-11-27 D-House

    学习了

    0

相关资讯

临床补液:每个医生必会的知识点 !精简总结 !

对于标准50kg病人,除外其他所有因素,一般禁食情况下,每天生理需要水量为2500-3000ml

补钾≠补氯化钾,正确补钾学起来

导读:补钾≠补氯化钾,正确认识补钾并选择合适的方法非常重要。钾在人体内的主要作用是维持酸碱平衡,参与能量代谢以及维持神经肌肉的正常功能。当体内缺钾时,会造成全身无力、疲乏、心跳减弱、头昏眼花,严重缺钾还会导致呼吸肌麻痹死亡。此外,低钾会使胃肠蠕动减慢,导致肠麻痹,加重厌食,出现恶心、呕吐、腹胀等症状。太多的盐与太少的钾会造成紧张与肌肉疲劳(现代的精盐已很少很少含有钾、镁等矿物质了,只是纯粹的氯

哪些患者要补液?烧伤、重症怎么补?这份补液攻略请收好!

补液治疗是指液体(如葡萄糖水、生理盐水、电解质、胶体等)通过输液或口服进入内环境的治疗方法,以纠正水、电解质、酸碱平衡紊乱和补充能量,恢复正常生理功能。

Neurology:地塞米松和补液可治疗卒中?

近期Neurology杂志发表了一篇文章,叙述了一例跨国界治疗急性卒中的病例。尽管在发达国家,缺血性卒中的治疗策略已经很完善,然而在中低收入国家中还缺少治疗的基本药物。该病例中的患者急性期治疗采取了地塞米松,胞二磷胆碱和补液治疗,却也能迅速恢复。欲知详情如何,且看全文分解: 患者Q先生,72岁,右利手。既往有高血压,高脂血症,复发性心绞痛。每年抽烟30包,他是一名退休的科学家,目前与

重症患者补液这门技术活 你掌握了吗?

液体复苏是解决危重患者血容量不足或休克的首要治疗措施,但补液量过度会引起肺水肿;补液量不足则引起组织氧合障碍,引起肾血管收缩(以保障重要脏器灌注)从而引发肾功能损伤。两者均会延长机械通气的时间,对病情不利,那么重症患者补液应如何权衡呢?量入为出人体内的体液通过以下几种途径排出体外。1. 肾脏排尿:每日尿量一般约为1000-1500 ml,至少500 ml。每日人体代谢产生35-40 g 固体废

临床补液的基本方法!

对于标准50kg病人,除外其他所有因素,一般禁食情况下,每天生理需要水量为2500-3000ml,下面我讲补液的量和质: