不同液体预输注对TUEVP患者循环及电解质的影响  

Effects of different fluids pre-infusing on hemodynamics and electrolytes in TUEVP

作　　者：王艳玲[1,2] 邓小文[3] 麻海春[1] 王虎山[1] 

机构地区：[1]吉林大学第一医院麻醉科,长春市130021 [2]中山大学附属第三医院麻醉科 [3]广州出入境检验检疫局

出　　处：《临床麻醉学杂志》2012年第1期51-53,共3页Journal of Clinical Anesthesiology

摘　　要：目的比较复方乳酸钠、6%羟乙基淀粉130/0.4、4%琥珀酰明胶预输注对维持短时间经尿道前列腺汽化电切术(TUEVP)中循环及电解质变化的影响。方法择期行TUEVP(65min以内)的患者36例,随机均分为三组,分别于麻醉前30min内预输注复方乳酸钠(L组)、6%羟乙基淀粉130/0.4(H组)和4%琥珀酰明胶(S组)10ml/kg,术中三组均以生理盐水维持循环稳定。于麻醉前(T0)、膀胱灌洗液用量6000ml(T1)、12000ml(T2)、出室前(T3)记录MAP、HR、Na+、K+、血糖等变化。结果 L组总输液量(包括预输注液体量)多于H组和S组(P<0.05)。T2、T3时L组MAP明显降低(P<0.05),且T3时明显低于H组和S组(P<0.05)。L组Na+浓度随灌洗液量的增加呈下降趋势。结论复方乳酸钠麻醉前预输注用于短时程TUEVP手术与6%羟乙基淀粉130/0.4或4%琥珀酰明胶比较,手术的中后期MAP和血Na+浓度呈下降趋势。Objective To investigate the effects of sodium lactate Ringer＇s, 60/00 hydroxyethyl starch and 4% succinylated gelatin pre-infusing on hemodynamics and electrolytes in short-term TUEVP. Methods Thirty-six patients scheduled for TUEVP（operation lasting within 65 minutes） were randomly divided into three groups： 6% hydroxyethyl starch 130/0.4 （group H）, 4%suceinylated gelatin（group S） and lactate Ringer＇s solution（group L）. The pre-infusion of the three fluids started before anesthesia with 10 ml/kg in 30 minutes adjusting to the weights, then, 0.9% natrium chloride was used to maintain the volume. Perioperative MAP, HR, Na＋ , K＋ , and blood glucose were recorded at the following times： before anesthesia （T0）, bladder irrigation amount of 6 000 ml （T1）, bladder irrigation amount of 12 000 ml （T2）, and before leaving the operating room （T3）. Results The total intravenous infusion volume in group L was higher than those in the other two groups（P〈0.05） ; MAP in group L decreased significantly at T2 and T3, compared with the other two groups, MAP was much lower at T3. The concentration of artery blood Na＋ appeared a downtrend associated with the irrigation fluid volume in group L. Conclusion Compared with 6 % hydroxyethyl starch and 4% succinylated gelatin, the pre-infusion of sodium lactate ringer＇s could result in a downtrend for the concentration of blood Na＋ and MAP at later period of surgery.

关 键 词：预输注 经尿道前列腺汽化电切术 复方乳酸钠 6%羟乙基淀粉 4%琥珀酰明胶 

分 类 号：R614[医药卫生—麻醉学]