钠钾镁钙葡萄糖注射液对上腹部手术患者术中糖代谢的影响  

Effects of sodium potassium magnesium calcium and glucose injection on patients′glucose metabolism undergoing upper abdominal surgery

作　　者：金利[1] 吴智方[1] 刘芳芳[1] 刘杨[1] 李伟彦[1] 

机构地区：[1]南京大学医学院临床学院南京军区南京总医院麻醉科,210002

出　　处：《中华临床医师杂志（电子版）》2012年第17期5162-5165,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的比较麻醉前钠钾镁钙葡萄糖注射液和乳酸林格液快速扩容对上腹部手术患者术中血糖(Glu)、糖代谢相关激素如:胰岛素(Ins)、胰高血糖素(GC)及皮质醇(Cor)以及糖代谢产物乳酸水平的影响。方法 40例择期上腹部手术患者随机平均分入钠钾镁钙葡萄糖注射液组(L组)和乳酸林格液组(R组)。两组入室后分别给予相应液体15 ml/kg,输注时间30 min。分别于输液前(T0)、输液后30 min(T1)、输液后60 min(T2)、输液后90 min(T3)及输液后120 min(T4)抽血,检测血糖、血气、电解质、乳酸,并于T0、T4时测定血中Ins、GC及Cor浓度。结果两组患者输液前后血钠、钾、镁、钙离子、pH、CO2、乳酸均无明显变化;R组血糖先略有下降随后升高,L组血糖一直呈升高趋势,但仅T1时L组血糖显著高于R组(P<0.05);两组T4时的Ins、Cor水平均显著高于T1时(P<0.05),但T1及T4时,L组与R组的Ins、Cor水平无统计学差异(P>0.05);T1及T4时,两组的GC无统计学差异。结论与乳酸林格液相比,钠钾镁钙葡萄糖注射液用于上腹部手术患者麻醉前快速扩容,不明显影响血糖、糖代谢相关激素以及糖代谢产物乳酸的水平。Objective To compare the effects of sodium potassium magnesium calcium and glucose injection infused just before anesthesia with sodium lactated Ringer injection on blood glucose,and glucose metabolism-related hormones such as:insulin(Ins),glucagons(GC)and cortisol(Cor),and glucose metabolism product as lactic acid in patients udergoing upper abdominal surgery.Methods Forty patients scheduled for upper abdominal surgery were randomly divided into sodium potassium magnesium calcium and glucose injection group(L group)and sodium lactated Ringer′s solution group(R group)(n=20).The patients in L group and R group were infused with 15 ml/kg of above-mentioned fluid respectively in 30 min just before anesthesia.Arterial blood was collected before infusion(T0)and 30,60,90,120 min after infusion(T1-4)to measure blood glucose,blood gas analysis,electrolyte and lactic acid.Insulin(Ins),glucagons(GC)and cortisol(Cor)were determined at T0 and T4.Results No significant difference was observed in blood sodium,potassium,magnesium,calcium,pH,CO2 and lactic acid between both groups.Blood glucose in L group was higher than R group at T1(P<0.05).Significant difference was observed in Ins and Cor within group but not between the two groups.There was no difference in GC within group and between the two groups.Conclusions Compared with sodium lactated Ringer injection,sodium potassium magnesium calcium and glucose injection infused rapidly just before anesthesia had similar impact on blood glucose,glucose metabolism-related hormones and glucose metabolism product as lactic acid in patients undergoing upper abdominal surgery.

关 键 词：血糖 钠钾镁钙葡萄糖注射液 乳酸林格氏液 

分 类 号：R656[医药卫生—外科学]