混合糖电解质在肠外营养应用中的稳定性评价  

Stability of carbohydrate and electrolyte injection for parenteral nutrition

作　　者：陈爱芬[1] 李强[2] 戴福仁[3] 叶可人[4] 陈烔 

机构地区：[1]瑞安市人民医院护理部,325200 [2]瑞安市人民医院中心实验室,325200 [3]瑞安市人民医院营养科,325200 [4]瑞安市人民医院药剂科,325200 [5]瑞安市人民医院烧伤科,325200

出　　处：《浙江医学》2009年第1期45-48,共4页Zhejiang Medical Journal

基　　金：温州市科技局科研课题（Y20080232）作者单位：（陈爱芬）,（李强）,（戴福仁）,药剂科（叶可人）,烧伤科（陈炯）

摘　　要：目的探索混合糖电解质作为能量补充剂配制肠外全营养混合液的稳定性及合理性。方法模拟临床应用处方并按照“全合一”混合原则，实验组营养液采用混合糖电解质为能量补充剂配制全营养混合液，对照组营养液使用10％葡萄糖注射液为能量补充剂配制全营养混合液，两组分别采用酸度计、微粒分析仪、渗透压仪、高倍显微镜等在室温下测定及观察配制营养液的0～72h的pH值、不溶性微粒数、微量元素、渗透压、脂肪乳滴的变化，比较两者之间的差异并进行稳定性分析评价。结果实验组pH值波动于6．07～633，渗透压波动于2050～2100kPa，pH值明显低于对照组（相差约0．4），实验组营养液渗透压明显高于对照组营养液（相差约250kPa），两者pH、渗透压经时变化曲线相似，72h内基本稳定；实验组营养液中Na^＋、K^＋、P、Mg^2＋、Ca^2＋、Cl^-的含量明显高于对照组，特别是二价离子Mg“、Ca“的含量相差近3倍；对照组营养液脂肪乳颗粒稳定性较好，12h内脂肪乳颗粒未发生明显聚集，实验组营养液脂肪乳颗粒稳定性较差，不溶性微粒数4h后超出药典规定，脂肪乳颗粒发生聚集且随时间延长颗粒明显增多增大。结论混合糖电解质注射液过高的离子浓度特别是二价离子易导致脂肪乳颗粒聚集，影响营养液的稳定性；不建议选用混合糖电解质作为全营养混合液唯一糖类补充剂使用，如需使用应和脂肪乳分别输注或在4h内输注完毕。Objective TO evaluate the stability and rationality of carbohydrate and electrolyte injection used as energy mixture in pareteral total nutrient admixture （TNA）. Methods According to the clinically applied prescription and ＂All-in-One＂ principle, we prepared total nutrient admixture. Carbohydrate and electrolyte injection was used as energy supplement agent in experiment group, while 10% glucose injection was used in control group. We tested and observed the changes of PH value, insoluble particles, microelement, osmotic pressure and lipid drop by PH meter, micro particles analysis instrument, osmotic pressure meter and high-power microscope under the room temperature 0-72 hours after the nutrition preparation in both groups. The differences between two groups were compared and stability of two groups were assessed and analyzed. Results In experiment group, PH value fluctuated between 6.07 -6.33, osmotic pressure between 2 050 -2 100 kPa. The PH value of experiment group was significantly lower than that of control group,and osmotic pressure of experiment group was significantly higher than that of control group. Curves of changes with time of PH and osmotic pressure in both groups were similar; and relatively stable within 72 hours. Contents of Na^＋, K^＋, P, Mg^2＋, Ca^2＋ and Cl^- in experiment group were all significantly higher than those in control group, while the difference of bivalence ions, Mg^2＋ and Ca^2＋ were almost three times. Stability of lipid particles in control group was better, and we did not find obvious aggregation of lipid particles within 12 hours. However, in experiment group, the number of insoluble particles was higher than the requirement of pharmacopeia after 4 hours, and lipid particles aggregation increased with time. Conclusion High content of ions, especially of bivalence ions in carbohydrate and electrolyte injection would result in lipid aggregation, therefore we do not recommend the carbohydrate and electrolyte injection as the only sugar supplement for pareter

关 键 词：混合糖电解质 全营养混合液 稳定性 配伍 

分 类 号：R927.11[医药卫生—药学] R318.02