全麻诱导期急性高容量血液稀释对老年患者血生化的影响  

Influence of acute high capacity hemodilution in induction period of general anesthesia on blood biochemistry of elder patients

作　　者：吴国荣[1] 陈骏萍[1] 王靖[1] 胡序凯[1] 

机构地区：[1]浙江省宁波市第二医院,浙江宁波315010

出　　处：《现代中西医结合杂志》2008年第5期657-659,共3页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的时比观察乳酸钠林格氏液和勃脉力A在老年患者术前急性高容量血液稀释前后血气、电解质、血糖、乳酸的变化。方法选择24例腹部择期手术老年患者，年龄65-76岁，ASAI-Ⅱ级，无心肺疾患，无高血压、糖尿病、肝功能、肾功能障碍病史。随机分为勃脉力A（BML）组和乳酸钠林格氏液（RL）组，患者入室开放静脉后分别给予2组液体15mL／kg，30min输注完毕，分别于输液前（T0）、后30min（T1）、60min（T2）、120min（T3），抽血查血气、电解质、血糖、乳酸。结果2组扩容前后钠离子、钾离子、血气无明显变化；血糖：RL组、BML组入室后都升高，且T3与T0比明显升高，P〈0.01。2组间各时点血糖值却无显著性差异；钙离子：BML组输液后明显降低，T1，T2，T3与T0相比P〈0.01。RL组各时点间无显著性差异。T1，T2，T3时点BML组钙离子显著低于RL组P〈0.01。红细胞体积比压力（HCT）、血红蛋白（Hb）：2组患者输液后均明显下降，T1，T2，T3与T0相比P〈0.01。但2组间各时点值却无显著性差异。结论勃脉力A用于急性高容量血液稀释时稳定机体生理内环境安全、有效，但可致血钙离子降低，注意加强监测。Objective It is to compare and observe the changes of natrium lacticum Ringer＇s solution and Bomaili A on blood gas analysis, electrolyte, blood sugar and lactic acid before and after acute high capacity hemodilution before operate of elder patients. Methods 24 elder patients who were scheduled to undergo abdominal surgery, 65-75 years of age, ASA I-Ⅱ and free of cardiopulmonary disease, hypertension, diabetes, liver disfunction and renal disfunction histories were chosen and randomly divided into Bomaili A （BML） group and natrium lacticum Ringer＇ s solution （RL） group. In operation rooms, they were infused injection 15 mL/kg respectively and finished in 30 min. They were drawn blood to examine blood gas anal- ysis, electrolyte, blood sugar and lactic acid before infusion （T0）, 30 min after infusion （T1）, 60 min after infusion （T2） and 120 rain after infusion （T3）. Results There were no significant difference on sodium ion, potassium ion and blood gas between the two groups before and after volume expansion. Blood sugar was increased in both groups, and T3 was higher than To obviously （P 〈 0.01 ）, but there were no significant difference between the two groups at the same time point. Calcium ion at T1, T2 and T3 was decreased significantly after infusion in BML group compared with that at T0（P〈0.01）. There was no significant difference among all time points in RL group. But Calcium ion in BML group was lower than that in RL group at T1, T2 and T3（P〈0.01）. Hematocrit （HCT） and hemoglobin （Hb） were decreased obviously after infusion in both groups at TI, T2 and T3 compared with that at T0 （P 〈 0.01）. However, there were no significant differences between the two groups at the same time point. Conclusion BML is safe and effective on stabilizing body physiological internal envi-ronment in acute high capacity hemodilution, but makes Calcium ion decreased. ,So, it is essential for strengthening monitoring.

关 键 词：勃脉力A 急性高容量血液稀释 老年患者 血生化 

分 类 号：R457.1[医药卫生—治疗学]