国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2014年
11期
1007-1011
,共5页
钠钾镁钙葡萄糖注射液%乳酸钠林格注射液%肝肾功能%血电解质%血糖%血乳酸%凝血功能
鈉鉀鎂鈣葡萄糖註射液%乳痠鈉林格註射液%肝腎功能%血電解質%血糖%血乳痠%凝血功能
납갑미개포도당주사액%유산납림격주사액%간신공능%혈전해질%혈당%혈유산%응혈공능
Sodium potassium magnesium calcium and glucose injection%Sodium lactate ringer injection%Hepatic and renal function%Electrolytes%Glucose%Lactate%Coagulation function
目的 评估钠钾镁钙葡萄糖注射液(sodium potassium magnesium calcium and glucose,SPMCG)术中输注对患者肝肾功能、血电解质、血糖、血乳酸及凝血功能的影响.方法 择期拟在全身麻醉下行普外科或骨科手术的患者80例,美国麻醉医师协会(ASA)分级Ⅰ级～Ⅱ级,采用随机数字表法分为实验组和对照组,每组40例.实验组给予SPMCG,对照组给予乳酸钠林格注射液.两组均以15 ml·kg-1·h-1的速度输注500 ml液体后行麻醉诱导,诱导后以10 ml·kg 1·h-1的速度维持输液2h,之后以8 ml·kg-1h-1的速度维持至手术结束.输液前后测定患者的肝肾功能、血电解质以及凝血功能,并监测输液前即刻、诱导前即刻、诱导后1、2h和输液结束时即刻各时间点的血乳酸和血糖值.结果 两组患者输注相应液体后,丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartateaminotransferase,AST)、白蛋白(albumin,ALB)、总胆红素(total bilirubin,TBIL)、血尿素氮(blood urea nitrogen,BUN)和血肌酐(serum creatinine,Cr)与输液前比较差异无统计学意义,组间比较差异无统计学意义.电解质方面,输液后2组Na+、K+、Cl-、Ca2+的浓度差异无统计学意义,但实验组输液后Mg2浓度较对照组高[(0.48±0.21) mmol/L vs(0.71±0.31) mmol/L(P＜0.05)].手术过程中2组患者血糖均逐渐上升,术后又下降至输液前水平.两种液体输注后,凝血酶原时间(prothrombin time,PT)和部分凝血活酶时间(activated partial thromboplastin time,APTT)无显著变化.结论 在术中输注SPMCG,对患者肝肾功能、血电解质、血糖、血乳酸及凝血功能无明显不良影响,并且相对于乳酸钠林格注射液,SPMCG能更好地维持血镁水平.
目的 評估鈉鉀鎂鈣葡萄糖註射液(sodium potassium magnesium calcium and glucose,SPMCG)術中輸註對患者肝腎功能、血電解質、血糖、血乳痠及凝血功能的影響.方法 擇期擬在全身痳醉下行普外科或骨科手術的患者80例,美國痳醉醫師協會(ASA)分級Ⅰ級～Ⅱ級,採用隨機數字錶法分為實驗組和對照組,每組40例.實驗組給予SPMCG,對照組給予乳痠鈉林格註射液.兩組均以15 ml·kg-1·h-1的速度輸註500 ml液體後行痳醉誘導,誘導後以10 ml·kg 1·h-1的速度維持輸液2h,之後以8 ml·kg-1h-1的速度維持至手術結束.輸液前後測定患者的肝腎功能、血電解質以及凝血功能,併鑑測輸液前即刻、誘導前即刻、誘導後1、2h和輸液結束時即刻各時間點的血乳痠和血糖值.結果 兩組患者輸註相應液體後,丙氨痠氨基轉移酶(alanine aminotransferase,ALT)、天門鼕氨痠氨基轉移酶(aspartateaminotransferase,AST)、白蛋白(albumin,ALB)、總膽紅素(total bilirubin,TBIL)、血尿素氮(blood urea nitrogen,BUN)和血肌酐(serum creatinine,Cr)與輸液前比較差異無統計學意義,組間比較差異無統計學意義.電解質方麵,輸液後2組Na+、K+、Cl-、Ca2+的濃度差異無統計學意義,但實驗組輸液後Mg2濃度較對照組高[(0.48±0.21) mmol/L vs(0.71±0.31) mmol/L(P＜0.05)].手術過程中2組患者血糖均逐漸上升,術後又下降至輸液前水平.兩種液體輸註後,凝血酶原時間(prothrombin time,PT)和部分凝血活酶時間(activated partial thromboplastin time,APTT)無顯著變化.結論 在術中輸註SPMCG,對患者肝腎功能、血電解質、血糖、血乳痠及凝血功能無明顯不良影響,併且相對于乳痠鈉林格註射液,SPMCG能更好地維持血鎂水平.
목적 평고납갑미개포도당주사액(sodium potassium magnesium calcium and glucose,SPMCG)술중수주대환자간신공능、혈전해질、혈당、혈유산급응혈공능적영향.방법 택기의재전신마취하행보외과혹골과수술적환자80례,미국마취의사협회(ASA)분급Ⅰ급～Ⅱ급,채용수궤수자표법분위실험조화대조조,매조40례.실험조급여SPMCG,대조조급여유산납림격주사액.량조균이15 ml·kg-1·h-1적속도수주500 ml액체후행마취유도,유도후이10 ml·kg 1·h-1적속도유지수액2h,지후이8 ml·kg-1h-1적속도유지지수술결속.수액전후측정환자적간신공능、혈전해질이급응혈공능,병감측수액전즉각、유도전즉각、유도후1、2h화수액결속시즉각각시간점적혈유산화혈당치.결과 량조환자수주상응액체후,병안산안기전이매(alanine aminotransferase,ALT)、천문동안산안기전이매(aspartateaminotransferase,AST)、백단백(albumin,ALB)、총담홍소(total bilirubin,TBIL)、혈뇨소담(blood urea nitrogen,BUN)화혈기항(serum creatinine,Cr)여수액전비교차이무통계학의의,조간비교차이무통계학의의.전해질방면,수액후2조Na+、K+、Cl-、Ca2+적농도차이무통계학의의,단실험조수액후Mg2농도교대조조고[(0.48±0.21) mmol/L vs(0.71±0.31) mmol/L(P＜0.05)].수술과정중2조환자혈당균축점상승,술후우하강지수액전수평.량충액체수주후,응혈매원시간(prothrombin time,PT)화부분응혈활매시간(activated partial thromboplastin time,APTT)무현저변화.결론 재술중수주SPMCG,대환자간신공능、혈전해질、혈당、혈유산급응혈공능무명현불량영향,병차상대우유산납림격주사액,SPMCG능경호지유지혈미수평.
Objective To evaluate influences of intraoperative sodium potassium magnesium calcium and glucose (SPMCG) injection infusion on hepatic and renal functions,blood electrolytes,glucose,lactate and coagulation function.Methods Eighty patients with ASA grade Ⅰ or Ⅱ scheduled for elective general surgery or orthopedic surgery were randomly assigned to experimental group and control group using random number table.Five hundred ml of SPMCG injection (in the experimental group) or sodium lactate ringer injection (in the control group) was infused at the rate of 15 ml·kg-1·h-1 before anesthesia induction,followed by 10 ml·kg-1 ·h-1 for 2 h,and then 8 ml·kg-1 ·h-1 until the end of surgery.Hepatic and renal functions,blood electrolytes and coagulation function were evaluated before and after infusion.Blood glucose and lactate levels were measured before infusion,pre-induction,and 1 h and 2 h after induction,and the end of infusion.Results There were not significantly differences between two groups in the serum levels of alanine aminotransferase,aspartate aminotransferase,albumin,total bilirubin,urea nitrogen and creatinine before and after infusion.The serum concentrations of Na+,K+,Cl-and Ca2+ before and after infusion did not significantly differ between two groups,but the serum concentration of Mg2+ after infusion was higher in the experimental group than in the control group [(0.84± 0.21) mmol/L vs(0.71 ±0.31) mmol/L(P＜0.05)].Blood glucose levels in the two groups increased progressively during surgery,and then decreased to preoperative levels after surgery.There were not significantly differences between two groups in the prothrombin time and activated partial thromboplastin time.Conclusions Intraoperative infusion of SPMCG injection does not result in harmful effects on hepatic and renal functions,blood electrolytes,glucose,lactate and coagulation function.Compared with sodium lactate ringer injection,SPMCG injection can better maintain the serum concentration of Mg2+ during surgery.
