麻醉前补偿性扩容对110例手术患者血酸碱平衡和电解质的影响  

Effect of pre-anesthetic compensatory volume expansion on blood acid-base balance and electrolytes in surgical patients:a report of 110 cases

作　　者：李新华[1] 陈堃[1] 代金贞[1] 徐卉[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉学教研室

出　　处：《临床外科杂志》2015年第5期360-362,共3页Journal of Clinical Surgery

摘　　要：目的：观察麻醉前补偿性扩容对手术患者血酸碱平衡和电解质的影响。方法随机选择 ASA Ⅰ～Ⅲ级择期手术患者110例，平均分为复方氯化钠注射液（R 组）和0．9％氯化钠注射液（N 组）两组。麻醉前补偿性扩容（CVE）则是在10～15 min 内快速静滴约8 ml／kg 两组溶液，在 CVE 前后分别血行血气分析，并比较 R、N 两组患者 CVE 前、后的差异。结果R 组、N 组患者CVE 前、后血气 pH、PaO2、Hb、Hct、Lac、HCO3比较，差异均有统计学意义（P ＜0．05），两组患者PaCO2比较差异无统计学意义。R 组患者 CVE 前、后 K ＋比较，差异有统计学意义（P ＜0．05）。N组患者 CVE 前、后 Na ＋、Cl －比较，差异有统计学意义（P ＜0．05）。结论择期手术患者于麻醉诱导前快速静滴8 ml／kg 复方氯化钠溶液，有助于提高麻醉诱导期的安全性。Objective To observe the effects of pre-anesthetic compensatory volume expansion （CVE）on blood acid-base balance and electrolytes in surgical patients.Methods A total of 110 ASA Ⅰ ~Ⅲ patients with scheduled surgery were randomly divided into Ringer＆#39;s solution group（R group）and nor-mal saline group（N group）.CVE indicated a rapid intravenous infusion of 8 ml/kg solutions within 10 ~15 min in both two group.Blood-gas analysis was used to compare the differences between the R group and the N group before and after CVE.Results The levels of pH,PaO2 ,Hb,Hct,Lac,and HCO3 - of the R group and N group were significantly different before and after CVE（P 〈0.05）.However,there was no significant difference in PaCO2 .In R group,there was significant difference in K ＋ before and after CVE （P 〈0.05）.In N group,there were significant differences in Na ＋ and Cl - before and after CVE（P 〈0.05）.Conclusion Rapid intravenous infusion of Ringer＆#39;s solution（8 ml/kg）in patients with selective surgery contributes to improve the safety during anesthesia inducement period.

关 键 词：补偿性扩容 酸碱平衡 血气分析 

分 类 号：R614[医药卫生—麻醉学]