神经外科术中输注不同晶体液对患儿电解质和血糖以及乳酸水平的影响  

Effects of sodium acetate Ringer solution on electrolytes, blood glucose and lactate levels in pediatric neurosurgery

作　　者：肖婷[1] 邝日裕[1] 张溪英[1] Xiao Ting;Kuang Riyu;Zhang Xiying(Department of Anesthesiology,Hunan Children's Hospital,Changsha 410007,Hunan,China)

机构地区：[1]湖南省儿童医院麻醉科,湖南长沙410007

出　　处：《中国中西医结合急救杂志》2019年第3期318-320,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：湖南省医药卫生科研计划项目(B2017117).

摘　　要：目的观察醋酸钠林格液对神经外科手术患儿围术期血清电解质、血糖(Glu)和乳酸(Lac)水平的影响.方法选择2018年12月至2019年4月湖南省儿童医院收治的40例行择期神经外科手术患儿,美国麻醉医师协会(ASA)分级Ⅰ~Ⅱ级.将患儿按随机数字表法分为醋酸钠林格液组和乳酸钠林格液组,每组20例.两组均给予相应的晶体液并以10mL·kg^-1·h^-1的速度输入.于麻醉诱导后(T1)、给药后1h(T2)、给药后2h(T3)和手术结束时(T4)测定动脉血气分析,观察两组患儿血清电解质浓度、Glu和Lac含量的变化.结果两组Glu及Lac随着手术时间延长均呈增高的趋势,而T3、T4时Glu和Lac均高于T1及T2时〔乳酸钠林格液组:Glu(mmol/L)为5.85±1.02、6.95±1.21比5.28±0.72、5.20±0.62,Lac(mmol/L)为1.53±0.74、1.91±1.41比1.23±0.71、1.38±0.69;醋酸钠林格液组:Glu(mmol/L)为5.44±0.86、5.85±1.12比5.05±0.85、5.14±0.74,Lac(mmol/L)为1.58±1.31、1.61±1.23比1.14±0.65、1.28±0.95,均P<0.05〕,且醋酸钠林格液组T4时Lac、Glu水平明显低于乳酸钠林格液组(均P<0.05).两组不同时间点pH值、Na^+、K^+和剩余碱(BE)水平比较差异均无统计学意义(均P>0.05).结论醋酸钠林格液用于2h以上小儿神经外科手术可降低其血Lac水平,不升高Glu,更适合小儿神经外科手术患儿术中输注.Objective To observe the effect of sodium acetate Ringer solution on serum levels of electrolytes, blood glucose (Glu) and lactic acid (Lac) in peri-operational stage of children undergoing neurosurgery. Methods Forty cases of children prepared to undergo neurosurgery admitted into Hunan Children's Hospital from December 2018 to April 2019 were enrolled, and according to the criteria of American Society of Anesthesiologists (ASA), they were classified into Ⅰ-Ⅱ grade. They were divided into a sodium acetate Ringer solution group and a sodium lactate Ringer solution group by random number table method, 20 cases in each group. Sodium acetate Ringer solution group was given the sodium acetate Ringer solution;sodium lactate Ringer solution group was given the sodium lactate Ringer solution, and both groups used intravenous infusion of their own respective solution at a rate of 10 mL·kg^-1·h^-1. Arterial blood gas detections were measured after anesthesia induction (T1), 1 hour after administration (T2), 2 hours after administration (T3) and at the end of surgery (T4);the changes in serum levels of electrolyte concentrations, blood Glu and Lac were observed in the patients of two groups. Results With the prolonged operation time, the levels of Glu and Lac in the two groups showed an increasing trend, compared with the levels at T1 and T2 , the levels were increased at T3 and T4 [the sodium lactate ringer solution group: Glu (mmol/L) were 5.85±1.02, 6.95±1.21 vs. 5.28±0.72, 5.20±0.62, and Lac (mmol/L) were 1.53±0.74, 1.91±1.41 vs. 1.23±0.71, 1.38±0.69;sodium acetate ringer solution group: Glu (mmol/L) was 5.44±0.86, 5.85±1.12 vs. 5.05±0.85, 5.14±0.74, Lac (mmol/L) were 1.58±1.31, 1.61±1.23 vs. 1.14±0.65, 1.28±0.95, all P < 0.05], the Lac and Glu levels at T4 in sodium acetate Ringer solution group were significantly lower than those in sodium lactate Ringer solution group (both P < 0.05). There were no statistically significant differences in pH value, Na^+, K^+ and residual base (BE) levels betwee

关 键 词：神经外科手术 患儿 醋酸钠林格液 乳酸钠林格液 

分 类 号：R977.7[医药卫生—药品]