瑞恤定在闭合性股骨骨折术后补液的应用  

Application of compound dextran 40 injection in the postoperative fluid therapy of closed femoral fracture

作　　者：刘国辉[1] 米博斌[1] 杨述华[1] 熊家伟[1] 李强[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院骨科,武汉430022

出　　处：《临床外科杂志》2012年第11期790-792,共3页Journal of Clinical Surgery

摘　　要：目的研究瑞恤定[复方右旋糖酐（40）注射液]在闭合性股骨骨折术后补液的应用价值。方法123例患者随机分为实验组（72例）和对照组（51例），实验组术后输瑞恤定，对照组术后输右旋糖酐（40）葡萄糖注射液，1000mL／d，连续5d，不足的液体及电解质按患者需要补充。监测患者术后生命体征、不良反应及输液5d后血电解质、血糖、血液流变学及凝血功能的变化。结果所有患者术后生命体征平稳。实验组1例，对照组4例出现不良反应。两组患者术后5d血K＋、cl＋、ca＋的正常率均相近，差异无统计学意义（P〉0．05），血清Na＋和血糖差异有统计学意义（9〈0．05）。两组患者血液流变学及凝血功能差异有统计学意义（P〈0．05）。结论术后患者应用瑞恤定，既能补充血容量，降低电解质和酸碱平衡紊乱的危险性，对血糖水平作用较小，又能降低血液黏滞度，改善微循环，延长凝血时间，降低血栓形成的风险。Objective To evaluate the value of compound dextran 40 injection in the postopera tive fluid therapy of closed femoral fracture. Methods One hundred and twentythree adult patients were enrolled and randomly divided into two groups：the test group （n = 72）and the control group （n = 51 ）. The test group accepted 1000 ml of compound dextran 40 injection for 5 days, while the control group accepted 1000 ml of of dextran 40 glucose injection. According to the need of the patient, extra fluids and electro lytes were supplied if necessary. Vital signs, adverse effects, blood electrolytes, blood glucose, hemarheology and blood coagulation were monitored 5 days after the infusion. Results All patients＂ vital signs were sta ble. There was 1 case of adverse effects in the test group and 4 cases of adverse effects in the control group. The differences in serum potassium, chlorine and calcium were not significant between the two groups. But the differences in serum natremia and glucose was significant. There was significant difference in hemarheology and blood coagulation between the two groups. Conclusion The compound dextran 40 can not only supplement the blood volume in patients after operation, but also decrease the risks of electro lyte and acidbase disorders. It has little influence on blood glucose. In addition, it can decrease the blood viscosity, improve the microcirculation, prolong the coagulation time, and reduce the risk of blood clots.

关 键 词：瑞恤定 电解质 血糖 凝血 

分 类 号：R683.42[医药卫生—骨科学]