醋酸钠林格氏液对胃肠道恶性肿瘤根治术患者酸碱及电解质的影响  

Effection of Acetated Ringer’s Solution on Acid-base Balance and Electrolyte Levels in Radical Surgery for Gastrointestinal Cancer

作　　者：闫瑞[1] 孙建洋[1] 陈雅儒[1] 孟尽海[1] YAN Rui;SUN Jianyang;CHEN Yaru;MENG Jinhai(Department of Anesthesiology,General Hospital of Ningxia Medical University,Yinchuan750004,China)

机构地区：[1]宁夏医科大学总医院麻醉科

出　　处：《宁夏医科大学学报》2019年第9期888-891,共4页Journal of Ningxia Medical University

基　　金：宁夏医科大学校级项目(XM2015073)

摘　　要：目的观察醋酸钠林格氏液对胃肠道恶性肿瘤根治术患者酸碱及电解质的影响。方法选择择期行胃癌或结直肠癌根治术患者60例,随机分为A组(醋酸钠林格氏液)及B组(复方氯化钠),每组30例。两组患者液体维持按照晶体液∶胶体液(羟乙基淀粉130/0.4注射液)=1∶1比例、10~15 mL·(kg·h)^-1的速度输注。分别于麻醉诱导即刻(T0)、肿瘤切除后(T1)、麻醉结束前(T2)抽取动脉血行血气分析。记录pH值、乳酸、电解质及碳酸氢钠用量等。结果A组患者中,与T0时比较,T1、T2时Hb、Hct浓度均降低(P均<0.05)、pH值及BE值均降低(P均<0.01);乳酸浓度变化差异无统计学意义(P>0.05)。B组患者中,与T0时比较,T1时乳酸浓度升高(P<0.05),Hb浓度降低(P<0.05),pH值、BE值及Hct浓度均降低(P均<0.01);T2时乳酸浓度升高(P<0.01),Hb及Hct浓度较低(P均<0.05),pH值、BE值及HCO3-浓度均降低(P均<0.01);与T1时比较,T2时B组BE值降低(P<0.05)。与A组比较,B组T2时乳酸浓度较高(P<0.05)。结论醋酸钠林格氏液可以改善胃肠道恶性肿瘤患者根治术中酸碱平衡。Objective To explore the effect of acetated Ringer’s solution on acid-base balance and electrolyte levels in radical surgery for gastrointestinal cancer.Methods Total 60 adult patients who undergoing radical surgery for gastrointestinal(gastric or colorectal)cancer were selected and randomly divided into the group A(acetated Ringer’s solution)and group B(compound sodium chloride).Each group consisted of 30 patients.The infusion of crystalloid solution in each group respectively fixed rate of 10-15mL·(kg·h)^-1(crystalloid:colloid,hydroxyethyl starch 130/0.4=1∶1).The blood gas from arterial blood sample at the time of anesthesia(T0),after removing cancer(T1)and the ending of anesthesia(T2)were analyzed.The pH value,lactic acid,acid-base and the dosage of sodium bicarbonate were recorded respectively.Results In group A,compared with T0,the concentration of Hb and HCT in T1 and T2 decreased(P all<0.05),pH value and be value decreased(P all<0.01),and there was no significant difference in lactate concentration(P>0.05).In group B,compared with T0,the concentration of lactate increased(P<0.05),the concentration of HB decreased(P<0.05),the concentration of pH,BE and HCT decreased(P all<0.01);the concentration of lactate increased(P<0.01),the concentration of Hb and hcct decreased(P all<0.05),the concentration of pH,BE and HCO3-decreased(P all<0.01).Compared with T1,the concentration of be decreased(P all<0.05)in group B in T2.Compared with group A,the concentration of lactate in group B was higher at T2(P<0.05).Conclusion Ringer’s solution can improve the acid-base imbalance in patients with gastrointestinal cancer.

关 键 词：醋酸钠林格氏液 胃肠道恶性肿瘤根治术 酸碱平衡 电解质 

分 类 号：R614[医药卫生—麻醉学] R735[医药卫生—外科学]