摘要
目的:观察醋酸林格氏液(勃脉力A)在肝癌根治术中对酸碱平衡和电解质的影响。方法:将42例拟于全麻下行肝癌根治术的患者随机分为两组,每组各21例,术中分别静脉输入勃脉力A(A组)和乳酸林格氏液(B组)。术中胶体液和血液制品的输入根据血压(BP)、心率(HR)、中心静脉压(CVP)和血红蛋白(Hb)等进行调节。于麻醉前(T0)、手术开始时(T1)、肿物切除后(T2)、手术结束时(T3)、术后8 h(T4)采取动脉血检测并记录血气、电解质及乳酸值,据检测结果适量输注碳酸氢钠、氯化钾及葡萄糖酸钙,并分别记录用量。结果:两组患者晶体、胶体液和血液制品输入量无统计学意义(P>0.05)。相比B组,A组使用碳酸氢钠的剂量显著降低,葡萄糖酸钙的剂量显著升高(P<0.05);氯化钾使用剂量无统计学意义(P>0.05)。A组乳酸值、pH值、BE值在不同时间点的比较差异无统计学意义(P>0.05),B组乳酸值、pH值、BE值在组间、组内比较差异均有显著性(P<0.05)。结论:勃脉力A用于肝癌根治术有利于动脉血酸碱平衡的稳定,对稳定机体内环境具有安全、有效的特点,但可引起血钙离子浓度降低,注意加强监测,并补钙。
Objective：To investigate the acid-base equilibrium and electrolyte effect of acetated Ringer＇s solution used on radical resection of liver cancer. Methods ：A total number of forty-tow adult patients who undergoing radical resection of liver cancer were assigned randomly to the acetated Ringerls solution group（group A）and the Lactated Ringer＇s solution（group B）. Each group consisted of 21cases. The infusion of colloid and blood products was regulated according to arterial blood pressure （BP）, heart rate （HR）, central venous pressure （CVP） and hemoglobin （Hb）. Detecting and recording blood gas,electrolyte and lactic acid before anesthesia （TO）,the beginning of operation（T1）,the removal of goiter （T2） ,the ending of operation （T3）, eight hours after operation （T4）, sodium bicarbonate, potassium chloride and calcium glueonate were infused to balance acid-base and electrolytes and the total dosages were recorded. Results ：The infusion of crystal,colloid and blood products were similar in each group（P〉0. 05）. Patients in group A required less sodium bicarbonate than those in group B,the infused volume of calcium gluconate in group A was sig- nificantly greater than group B （P〈 0. 05）. The dosage of potassium chloride was similar in each group （P〉 0.05）. The lactic acid ,arterial pH and BE were similar all the time point in group A（P〉0. 05） ,and in group B lactic acid ,arterial pH and BE were significantly different （P〈0. 05）. Conclusion：The maintenance of stabilizing organism internal environment is safety and effective of acetated Ringerls solution used on radical resection of liver cancer,decreasing lactic acid concentration,but blood calciumion concentration is degrading,so we must detect exactly and add calcium to the body.
出处
《临床医药实践》
2010年第8期585-587,共3页
Proceeding of Clinical Medicine
关键词
醋酸林格氏液
肝癌根治术
酸碱平衡
电解质
aeetated ringer＇s solution,radical operation of liver cancer
acid-base balance
electrolyte
