钠钾镁钙葡萄糖注射液对不停跳冠状动脉旁路移植患者术中血糖水平的影响  

Sodium potassium magnesium calcium and glucose injection 's effects on blood glucose levels of patients undergoing coronary artery bypass surgery

作　　者：兰琼[1] 郑清[1] 吕誉芳[2] 赵丽云[2] 景赫[2] 

机构地区：[1]北京大学第三医院麻醉科,100191 [2]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所麻醉科

出　　处：《心肺血管病杂志》2016年第6期453-456,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:观察输注钠钾镁钙葡萄糖注射液对不停跳冠状动脉旁路移植术(OPCABG)患者术中血糖水平的影响。方法:选择期血糖正常的OPCABG患者60例,随机分为试验组(A组)和对照组(B组)。在输液前抽取动脉血气,两组患者均以8 m L·kg^(-1)·h^(-1)的速度持续输注晶体液直至冠状动脉血管吻合前停止。分别检测并记录输液前即刻(T0)、劈完胸骨即刻(T1)、行血管吻合前(T2)的血糖数据及术前空腹时血糖、术前糖化血红蛋白Hb A1c数据。结果:A组与B组空腹血糖、Hb A1c均数比较无差异,超过5.7%糖化血红蛋白的比例分别是50.0%与56.7%,两组结果相比较,差异无统计学意义。A组血糖随着输液量的增加逐步上升,幅度先低后高,T1、T2与基线T0比较差异有统计学意义。B组血糖随着输液量的增加先略降低然后显著升高,T2与基线T0比较差异有统计学意义。两组组间比较T1时点血糖差异有统计学意义(P<0.01)。结论:在OPCABG患者术中持续低速度(8 m L·kg^(-1)·h^(-1))输注1%葡萄糖钠钾镁钙葡萄糖注射液,与不含糖溶液相比较,并没有显著增加血糖水平,而且可有效维持术中血糖浓度于6.11~8.33mmol/L的较理想水平。Objective： To compare the effects of infusion with Sodium potassium magnesium calcium and glucose injection and Sodium lactate finger injection on intraoperative blood glucose in patients with normal blood glucose undergoing off-pump coronary artery bypass surgery （OPCABG）. Methods： 60 patients with normal fasting blood glucose undergoing OPCABG were randomly divided into group A （ n = 30 ） and group B （ n = 30）. Following extraction arterial blood gas before infusion, group A was continued infusing with Sodium potas-sium magnesium calcium and glucose injection while group B with Sodium lactate finger injection at the rate of 8 ml·kg^-1·h^-1 until moving heart to coronary vascular anastomosis. During the period, regulating colloid infusion rate and the amount of vasoactive medicinal to maintain mean arterial pressure at 70 - 90 mmHg. Blood glucose was detected and recorded at immediately before infusion （TO）, finishing splitting sternum instantly （T1）, before vascular anastomosis （T2） respectively. Preoperative fasting blood glucose, glycosylated hemoglobin Ale were recorded respectively. Results： The proportion of glycosylated hemoglobin greater than 5.7% is 50% and 56. 67% respectively, with no significant difference between the two groups. Blood glucose gradually increased with increasing crystalloid solution infusion volume in group A, and the increasing rate gradually became larger. Compared with baseline T0, there was statistically significant difference in blood glucose at T1 and T2 in group A. In group B, blood glucose slightly decreased from T0 to T1, then obviously increased from T1 to T2. Com- pared with baseline TO, there was statistically significant difference at T2 in group B. There was statistically significant difference at T1 between two groups （ P 〈 0. 01 ）. Conclusion： Compared with Sodium lactate ringer injection, sodium potassium magnesium calcium and glucose injection containing 1% glucose did not significantly increase blood glucose levels in patient

关 键 词：复方乳酸钠注射液 钠钾镁钙葡萄糖注射液 不停跳冠状动脉搭桥术 血糖 

分 类 号：R54[医药卫生—心血管疾病]