混合糖电解质注射液在择期便秘外科手术患者术后补液中的应用  

Effect of carbohydrate- electrolyte solution on the fluid balance and glucose metabolism in patients after selective operations for constipation

作　　者：姜婷婷[1] 王新颖[1] 姜军[1] 刘思彤[1] 李宁[1] 

机构地区：[1]南京大学医学院附属金陵医院(南京军区南京总医院)普通外科研究所,210002

出　　处：《中华普通外科学文献（电子版）》2015年第6期441-445,共5页Chinese Archives of General Surgery(Electronic Edition)

摘　　要：目的探究混合糖电解质注射液在择期便秘外科手术患者术后应用是否能够稳定血糖、减轻乳酸堆积、补充血电解质。方法筛选2013年11月至2014年1月有明确诊断的64例择期便秘外科手术患者,随机分为试验组(33例)和对照组(31例),分别给予混合糖电解质注射液和10%葡萄糖电解质注射液。术后连续输注3 d,每天1 000 ml,不足部分按需补充。监测患者手术前和手术后3 d每次输液前后的血糖、乳酸水平及钙、镁、磷离子水平。结果受试者均未出现相关不良反应或肝肾功能损害。两组患者手术后的血糖与手术前相比均有所升高,但在各时间点及各时间点与手术前的差值之间差异并无统计学意义,但对照组的血糖波动范围较大,试验组的血糖水平相对较为平稳。两组患者的血乳酸、血钙、血镁水平差异无统计学意义。自术后第2天起,试验组血磷水平明显高于对照组,术后第1天输液后至第3天输液前两组血磷水平均低于正常范围;而术后第3天输液后,试验组血磷水平恢复至正常范围,而对照组仍低于正常范围(P<0.05)。结论择期便秘外科手术患者术后应用混合糖电解质注射液治疗既能对血糖水平有稳定作用,又能对血磷进行补充,是目前临床液体治疗的优先选择。Objective To evaluate the effect of carbohydrate-electrolyte solution on the fluid balance and glucose metabolism in patients after selective operations for constipation. Methods Sixtyfour adult patients after selective operations for constipation from November 2013 to January 2014 were enrolled and randomly divided into two groups: test group(33 cases) and control group(31 cases). The test group accepted the fluid therapy of carbohydrate- electrolyte solution, while the control group accepted the fluid of compound electrolyte and glucose solution for 3 days of 1 000 ml/d. The blood glucose, calcium, magnesium and phosphorus before the operations, before and after infusion in 3 days after operations were assayed. Results No adverse reactions occurred in all patients. There was no difference in general characteristics of patients between two groups. The increase of serum glucose was observed in the two groups after operations, while there was no statistical significance between groups. The fluctuation range of serum glucose in the test group was smaller than the control group. There was no statistical significance in serum lactic acid, calcium and magnesium between groups. The serum phosphorus was below the normal level in both the test group and the control group from the first day after infusion to the third day before infusion. However, it recovered to the normal level after infusion in three days in the test group but remained abnormal in the control group(P<0.05), which suggested the supplementary effect of carbohydrate-electrolyte solution. Conclusions The carbohydrate-electrolyte solution can not only maintain stability of serum glucose, but also supplement serum phosphorus in patients after selective operations for constipation. It is a favorable choice in clinical fluid treatment.

关 键 词：便秘 血糖 电解质 磷 混合糖电解质注射液 择期手术 

分 类 号：R656.9[医药卫生—外科学]