钠钾镁钙葡萄糖注射液扩容对术中血糖、电解质和酸碱平衡的影响

目的比较钠钾镁钙葡萄糖注射液和复方乳酸钠注射液扩容对术中血糖、电解质及酸碱平衡的影响。方法择期行胃肠道手术患者30例,采用随机数字法分为研究组(n=16)和对照组(n=14),研究组使用钠钾镁钙葡萄糖注射液扩容,对照组使用复方乳酸钠注射液扩容,分别在入室后以15ml·kg-1·h-1的速度输注相应液体。分别于输液前(T0)、输液量为10ml/kg(T1)、20ml/kg(T2)和30ml/kg(T3)时检测患者血糖、血乳酸、电解质及pH值等。结果输液后研究组血糖明显升高(P<0.05),血乳酸无明显变化,血pH明显降低(P<0.05);对照组血乳酸明显升高(P<0.05);两组电解质水平均无明显变化。结论钠钾镁钙葡萄糖注射液在扩容、维持电解质及酸碱平衡方面与复方乳酸钠注射液效果相当,可避免大量输入复方乳酸钠注射液所致的乳酸升高,但当大量输注钠钾镁钙葡萄糖注射液时可导致一定程度的血糖升高。

Effects of volume replacement with sodium potassium magnesium calcium and glucose injection on intraoperative blood glucose, electrolytes, and acid-base balance

Objective To compare the effects of volume replacement with sodium potassium magnesium calcium and glucose injection and lactate Ringer’s injection on intraoperative blood glucose,electrolytes,and acid-base balence.Methods Thirty patients scheduled for elective gastrointestinal surgery were randomly divided into experimental group(group E,n=16)and control group(group C,n=14).Group E was infused with sodium potassium magnesium calcium and glucose injection while group C was infused with sodium lactate Ringer’s injection for volume replacement at the rate of 15 ml·kg-1·h-1.Arterial blood glucose,lactate,electrolytes,and pH were measured before infusion(T0),at the time of the infusion volume reaching 10 ml/kg(T1),20 ml/kg(T2),and 30 ml/kg(T3).Results Compared with T0,blood glucose was increased and pH was decreased(P<0.05),while no significant change in lactate w as found in group E after fluid replacement;blood lactate was increased in group C(P<0.05);no significant changes in electrolytes were found in both groups.Conclusion Sodium potassium magnesium calcium and glucose injection has the equivalent effects on volume expansion and the maintenance of electrolytes and acid-base balance as sodium lactate Ringer’s injection.It can avoid the hyperlactacidemia caused by large volume of lactate Ringer’s injection,but large volume infusion of this injection can lead to hyperglycemia.