Utilization of intravenous glucose and fructose in the postoperative period.

A comparison is made between the utilization of glucose and fructose given intravenously at the rates of 1 g kg-1 h-1 and 0.5 kg-1 h-1 to 6 and 10 patients, respectively, who had undergone stomach surgery. Each patient served as his own control. The maximum rise in the total blood sugar concentration during both the rapid and the slow glucose infusions (227 mg% and 171 mg%) was significantly larger than during the fructose infusions (86 mg% and 52 mg%). The maximum rise in blood glucose of an average 23 and 18 mg% during the administration of fructose seems to indicate that only a small percentage of fructose is converted directly to glucose. Hypoglycemia after the infusions was most pronounced after the use of glucose. During the rapid infusions the patients lost a significantly larger amount of the infused sugar in the urine when glucose was administered (12.9% vs 4.7%), and the greater loss of sugar was accompanied by a greater loss of water. During the slow infusions there was no difference in sugar excretion between the two carbohydrates. At the infusion rate of 0.5 g kg-1 h-1 6 times as much lactate was excreted during the fructose infusions as during the glucose infusions (1.8 mg as compared with 0.3 mg lactate kg-1 infusion h-1). The study seems to indicate that there is a renal threshold for lactate at blood concentrations of 10-15 mg%.     

子痫前期围术期持续静脉滴注呋塞米的临床价值

目的探讨子痫前期围手术期应用呋塞米静脉滴注的疗效。方法将笔者所在医院产科收治的重度子痫前期行剖宫产治疗患者103例随机分为观察组51例,对照组52例。两组均进行常规围手术期治疗,观察组同时还给予呋塞米持续静滴。观察两组患者血氧饱和度、尿量、肺水肿发生情况等,并进行比较。结果两组术后平均动脉压均显著下降,组间比较有统计学意义（P〈0.05）;术后两组24h尿量均明显增加（P〈0.05）,且观察组较对照组增加,两组比较有统计学意义（P〈0.05）。术后观察组急性肺水肿发生率为3.9%,对照组为19.2%,两组急性肺水肿发生率差异有统计学意义（x2=4.71,P〈0.05）。结论呋塞米持续静脉滴注能显著降低重度子痫前期患者血压,促进其尿量恢复,显著降低术后肺水肿发生率。     

Prolonged postoperative analgesia in abdominal surgery

One hundred and sixty-two patients operated on organs of lower part of abdominal cavity were studied. All the patients were divided into 3 groups depending on anesthesia method: general, epidural and spinal anesthesia. Efficacy of different methods of intrasurgical anesthesia for prevention of postoperative algetic syndrome and decrease of complications number was compared. It is demonstrated that spinal and epidural anesthesia ensure prophylaxis of postoperative algetic syndrome, but spinal anesthesia is the most simple, safe and cost-effective method.