骨病患儿围术期不同液体输注对糖代谢及电解质酸碱平衡的影响比较  

Effects of infusing different fluids intravenously on carbohydrate metabolism and plasma electrolytes and acid-base balance in perioperative children undergoing bone surgery

作　　者：侯南丽[1] 邱斐斐[1] 

机构地区：[1]文登整骨医院麻醉科,山东威海264400

出　　处：《实用医药杂志》2016年第9期784-787,共4页Practical Journal of Medicine & Pharmacy

摘　　要：目的 观察围术期输注不同液体对骨病患儿血糖、血酮体及电解质酸碱平衡的影响。方法 选择ASAⅠ-Ⅱ级骨科手术患儿80例,年龄1-6岁;男46例,女34例,体重11-22 kg,禁饮食8-10 h,随机分成四组：钠钾镁钙葡萄糖注射液组（Ⅰ组）、乳酸钠林格组（Ⅱ组）、5%葡萄糖组（Ⅲ组）和生理盐水组（Ⅳ组）,各组患儿分别于术中根据体重、禁饮食时间及术中失血量等输注相应液体。记录患儿术中的输液量、尿量,并在输液前（T0）和麻醉结束时（T1）抽取血样检测血糖、血酮体及血p H值、血钠、钾离子浓度。结果 Ⅲ组患儿尿量与其他三组比较有统计学差异（P〈0.05）。四组患儿术前各项血液检测指标组间比较无统计学意义（P〉0.05）。与T0时比较,Ⅰ组和Ⅲ组T1时血糖升高（P〈0.05）,并且Ⅰ组和Ⅲ组组间比较存在统计学差异（P〈0.05）;Ⅱ组血糖在T1时无明显降低（P〉0.05）和Ⅳ组血糖在T1时降低（P〈0.05）,但仍在正常范围内,组间比较无统计学差异（P〉0.05）。与T0时比较,Ⅰ组和Ⅲ组血酮体在T1时无明显变化（P〉0.05）,组间比较无统计学差异（P〉0.05）;Ⅱ组和Ⅳ组血酮体在T1时升高（P〈0.05）,组间比较无统计学差异（P〉0.05）。与T0时比较,Ⅳ组T1时血钠升高（P〈0.05）,Ⅰ组和Ⅱ组略有降低,但无统计学意义（P〉0.05）,Ⅲ组术后血钠出现明显下降（P〈0.05）,但尚在正常范围内。与T0时比较,Ⅰ组和Ⅱ组术后血钾无明显变化（P〉0.05）,Ⅲ组和Ⅳ组明显下降（P〈0.05）。各组患儿p H值组内和组间比较均无统计学意义（P〉0.05）。结论 骨病患儿围术期输注钠钾镁钙葡萄糖注射液更有利于维持血糖及电解质酸碱平衡。Objective To evaluate the effects of intravenously infusing different fluids on plasma electrolytes glucose,ketone body levels and electrolytes ＆ acid-base balance in perioperative children. Methods Eighty ASA Ⅰ or Ⅱpatients：34 females 46 males,aged from one year to 6 years,weight from 11 kg to 22kg,fasting time from 8 h to 10 h,received scheduled orthopedics surgery;they were equally randomized into 4 groups and received corresponding fluid i.v：Group Ⅰ ：Glucose injection of sodium potassium magnesium calcium;Group Ⅱ ： sodium lactate Ringer＇s solution;Group Ⅲ ：five percent glucose injection;Group Ⅳ ：Normal saline according to their body weight,fasting time and intraoperative blood loss plasma sodium levels,plasma potassium levels,pH and glucose levels,ketone body levels were detected and recorded at the beginning（T0） and anaesthesia end （T1）. The volume of infusion and urine volume at the operation were recorded. Results Urine volume of Group Ⅲ had significant difference compared with the other three group at the anaesthesia end （P〈0.05）. There were no significant differences in the indexes among the groups at the beginning （T0）（P〉0.05）. Compared with T0,glucose leves increased at T1 in Group I and Group m （P〈0.05）,and there was significant differences between Group Ⅰ and Group Ⅲ （P〈0.05）. There were no significant differences at T1 in Group Ⅱ compared with To （P〉0.05）. Glucose levels at T1 Group IV decreased （P〈0.05）,but still were within the normal range. There were no significant difference between Group Ⅱ and Group Ⅳ（P〉0.05）. Compared with T0,plasma ketone body levels had no significant change at T1 in Group Ⅰ and Group Ⅲ （P〉0.05） and increased in Group Ⅱ and Group Ⅳ （P〈 0.05）. Compared with T0,plasma sodium levels increased at T1 in Group IV （P〈0.05） and decreased in Group Ⅲ（P〈0.05）. There were no significant difference in Group Ⅰ and Group Ⅱ （P〉0.05）. Compared with T0,pla

关 键 词：小儿 钠钾镁钙葡萄糖注射液 乳酸钠林格氏液 电解质 酸碱平衡 

分 类 号：R68[医药卫生—骨科学] R457.2[医药卫生—外科学]