钠钾镁钙葡萄糖注射液术中输注对患者肝肾功能、血电解质、血糖、血乳酸及凝血功能的影响  

The influences of intraoperative sodium potassium magnesium calcium, glucose injection infusion on hepatic and renal functions, blood electrolytes, glucose, lactate and coagulation function

作　　者：张亮 吴佐满 范晓华[2] 

机构地区：[1]张家港澳洋医院麻醉科,215600 [2]上海第二军医大学附属长海医院麻醉科

出　　处：《国际麻醉学与复苏杂志》2014年第11期1007-1011,共5页International Journal of Anesthesiology and Resuscitation

摘　　要：目的 评估钠钾镁钙葡萄糖注射液（sodium potassium magnesium calcium and glucose,SPMCG）术中输注对患者肝肾功能、血电解质、血糖、血乳酸及凝血功能的影响.方法 择期拟在全身麻醉下行普外科或骨科手术的患者80例,美国麻醉医师协会（ASA）分级Ⅰ级～Ⅱ级,采用随机数字表法分为实验组和对照组,每组40例.实验组给予SPMCG,对照组给予乳酸钠林格注射液.两组均以15 ml·kg-1·h-1的速度输注500 ml液体后行麻醉诱导,诱导后以10 ml·kg 1·h-1的速度维持输液2h,之后以8 ml·kg-1h-1的速度维持至手术结束.输液前后测定患者的肝肾功能、血电解质以及凝血功能,并监测输液前即刻、诱导前即刻、诱导后1、2h和输液结束时即刻各时间点的血乳酸和血糖值.结果 两组患者输注相应液体后,丙氨酸氨基转移酶（alanine aminotransferase,ALT）、天门冬氨酸氨基转移酶（aspartateaminotransferase,AST）、白蛋白（albumin,ALB）、总胆红素（total bilirubin,TBIL）、血尿素氮（blood urea nitrogen,BUN）和血肌酐（serum creatinine,Cr）与输液前比较差异无统计学意义,组间比较差异无统计学意义.电解质方面,输液后2组Na＋、K＋、Cl-、Ca2＋的浓度差异无统计学意义,但实验组输液后Mg2浓度较对照组高[（0.48±0.21） mmol/L vs（0.71±0.31） mmol/L（P＜0.05）].手术过程中2组患者血糖均逐渐上升,术后又下降至输液前水平.两种液体输注后,凝血酶原时间（prothrombin time,PT）和部分凝血活酶时间（activated partial thromboplastin time,APTT）无显著变化.结论 在术中输注SPMCG,对患者肝肾功能、血电解质、血糖、血乳酸及凝血功能无明显不良影响,并且相对于乳酸钠林格注射液,SPMCG能更好地维持血镁水平.Objective To evaluate influences of intraoperative sodium potassium magnesium calcium and glucose （SPMCG） injection infusion on hepatic and renal functions,blood electrolytes,glucose,lactate and coagulation function.Methods Eighty patients with ASA grade Ⅰ or Ⅱ scheduled for elective general surgery or orthopedic surgery were randomly assigned to experimental group and control group using random number table.Five hundred ml of SPMCG injection （in the experimental group） or sodium lactate ringer injection （in the control group） was infused at the rate of 15 ml·kg-1·h-1 before anesthesia induction,followed by 10 ml·kg-1 ·h-1 for 2 h,and then 8 ml·kg-1 ·h-1 until the end of surgery.Hepatic and renal functions,blood electrolytes and coagulation function were evaluated before and after infusion.Blood glucose and lactate levels were measured before infusion,pre-induction,and 1 h and 2 h after induction,and the end of infusion.Results There were not significantly differences between two groups in the serum levels of alanine aminotransferase,aspartate aminotransferase,albumin,total bilirubin,urea nitrogen and creatinine before and after infusion.The serum concentrations of Na＋,K＋,Cl-and Ca2＋ before and after infusion did not significantly differ between two groups,but the serum concentration of Mg2＋ after infusion was higher in the experimental group than in the control group [（0.84± 0.21） mmol/L vs（0.71 ±0.31） mmol/L（P〈0.05）].Blood glucose levels in the two groups increased progressively during surgery,and then decreased to preoperative levels after surgery.There were not significantly differences between two groups in the prothrombin time and activated partial thromboplastin time.Conclusions Intraoperative infusion of SPMCG injection does not result in harmful effects on hepatic and renal functions,blood electrolytes,glucose,lactate and coagulation function.Compared with sodium lactate ringer injection,SPMCG injection can better maintain the serum concentration of Mg2＋ du

关 键 词：钠钾镁钙葡萄糖注射液 乳酸钠林格注射液 肝肾功能 血电解质 血糖 血乳酸 凝血功能 

分 类 号：R614[医药卫生—麻醉学]