钠钾镁钙葡萄糖注射液用于术中输液治疗对患者内环境的影响  

Effect of sodium potassium magnesium calcium and glucose injection on internal environment during surgery

作　　者：李博[1] 刘骥[2] 范勤 魏玮[1] 季名飞[1] 范晓华[1] 

机构地区：[1]第二军医大学附属长海医院麻醉科,上海200433 [2]解放军306医院麻醉科 [3]解放军空军医院麻醉科

出　　处：《上海医学》2012年第4期280-283,共4页Shanghai Medical Journal

摘　　要：目的以乳酸钠林格注射液为对照,评估术中输注钠钾镁钙葡萄糖注射液对患者内环境的影响。方法选择全身麻醉下行普外科或骨科手术的患者82例,美国麻醉医师学会分级为Ⅰ～Ⅱ级,随机分为试验组和对照组,分别使用钠钾镁钙葡萄糖注射液和乳酸钠林格注射液。用微量静脉输液泵控制输液,开始以15mL.kg-1.h-1的速度输注500mL,随后以10mL.kg-1.h-1的速度维持2h,然后以8mL.kg-1.h-1的速度维持至手术结束。记录患者的麻醉药物使用剂量、手术时间、术中失血量、平均尿量、输血量、输血浆量、输胶体液量及输试验液量。分别于输液前,输液后10和20min,诱导前即刻,诱导后1、2、3、4h,输液结束时,以及输液结束后1h监测患者的血流动力学指标;输液前和诱导前即刻,诱导后1、2、3、4h,以及输液结束即刻监测患者的动脉血气分析和血糖。于输液前、后检测患者的血电解质和肾功能指标。结果两组间麻醉药物使用剂量、手术时间、术中失血量、平均尿量、输血量、输血浆量、输胶体液量及输试验液体量的差异均无统计学意义(P值均>0.05)。两组的心率和平均动脉压在麻醉后均有所下降,在麻醉维持期间保持平稳,在手术结束后恢复至麻醉前水平,组间及组内的差异均无统计学意义(P值均>0.05)。两组的血糖水平均随输注试验液体量的增加而逐渐升高,停止输注试验液体后降至输液前水平。两组的血pH值和乳酸水平均无明显变化,剩余碱随着输注试验液体量的增加而逐渐下降,但均在正常范围内,组间及组内的差异均无统计学意义(P值均>0.05)。两组间输注试验液体前后Na+、K+、Cl-、Ca2+、尿素氮、肌酐的差异均无统计学意义(P值均>0.05),对照组输注试验液体后Mg2+水平显著低于试验组(P<0.05)。结论与输注乳酸钠林格注射液相比,在手术中输注钠钾镁钙葡萄糖注射液对患者内环境的稳定�Objective To investigate the effect of sodium potassium magnesium calcium and glucose injection on internal environment during surgery. Methods Totally 82 patients with American Society of Anesthesiologists （ASA） I or n＂ were scheduled for general or orthopedic surgery and randomly divided into experimental group and control group. Under the control of microinfusion pump, 500 ml_ sodium lactate ringer＇s injection （control group） or 500 mL sodium potassium magnesium calcium and glucose injection （experimental group） was infused at a speed of 15 mL .kg-1 h-1. Then the infusion continued at a speed of 10 mL.kg-0 . h-1 for 2 h, and at a speed of 8 mL. kg-1 . h-1 until the operation was finished. The consumption of anesthetic drugs, operation time, intraoperative blood loss, average urine volume, blood transfusion volume, plasma transfusion volume, colloidal fluid transfusion volume and experimental fluid transfusion volume were recorded. Hemodynamic parameters were measured before infusion, 10 min and 20 min after infusion, before induction, 1 h, 2 h, 3 h, and 4 h after induction, at the end of infusion, and 1 h after infusion. Arterial blood gas analysis and blood glucose were assessed before infusion, before induction, i h, 2 h, 3 h and 4 h after induction, and at the end of infusion. Renal function and blood biochemistry tests were performed before and after infusion. Results There was no significant difference in the consumption of anesthetic drugs, operation time, intraoperative blood loss, average urine volume,blood transfusion volume, plasma transfusion volume, colloidal fluid transfusion volume or experimental fluid transfusion volume between both groups （P^0.05）. Heart rate and mean arterial blood pressure decreased after induction of anesthesia, kept stably in the maintenance of anesthesia, and restored to the preoperative level after surgery. There were no significant intragroup and intergroup differences in heart rate and mean arterial blood pressure （P〉0.05）. Blood glucose was i

关 键 词：钠钾镁钙葡萄糖注射液 乳酸钠林格注射液 液体治疗 内环境 

分 类 号：R614[医药卫生—麻醉学]