复方果糖电解质注射液在肾移植后多尿期补液中的临床应用研究

Clinical use of compound fructose electrolyte solution in diuresis stage after kidney transplantation

目的 观察复方果糖电解质注射液在肾移植术后多尿期的补液效果。方法 回顾性分析2004年1月－2013年12月上海长征医院1279例肾移植后多尿期的补液治疗方案，均采用复方果糖电解质注射液补液，监测患者的血电解质、血糖、尿糖、二氧化碳结合力（CO2CP）及肾功能变化情况。结果 肾移植后多尿期尿量峰值出现在术后3～9h，其中最高尿量达到2500ml/h。血钠、钾、氯均在正常范围，血钙处于正常范围的下限，CO2CP在正常范围，血肌酐浓度随时间推移而明显下降。术前患者血糖均控制在正常范围内，术后血糖水平略有上升，但多处于正常范围上限或者稍高于正常值，且术后1周内未出现血糖的剧烈波动。尿糖受手术的影响更小，术后无升高趋势。结论 复方果糖电解质注射液可较好地维持肾移植后多尿期的水、电解质和酸碱平衡，并能有效解决传统循环补液治疗存在的液体种类多、操作繁琐和高血糖等问题。

Objective To evaluate the effect of compound fructose electrolyte solution in the diuresis stage after kidney transplantation. Methods The rehydration therapy was retrospectively analyzed in 1279 cases of diuresis stage after renal transplantation in Changzheng Hospital from Jan. 2004 to Dec. 2013. All the patients received compound fructose electrolyte solution intravenously, and the changes in blood electrolytes, blood glucose, urine glucose, CO2 combining power （CO2CP）, and renal function were monitored and analyzed. Results The peak of urine volume after kidney transplantation appeared during 3-9 hours after operation, and the highest urine volume reached 2500ml/h. The concentration of blood sodium, potassium and chlorine were in normal range, while the concentrations of blood calcium was in the lower limit of its normal range. The CO2CP was in normal range, and serum creatinine concentration decreased remarkably as the time went by. Blood glucose was controlled within normal range before surgery, and increased a little or slightly over the normal range with smooth fluctuation within a week after operation. The urine glucose was less influenced without any increasing trend within 1 week after operation. Conclusion Compound fructose electrolyte solution showed a great potential in maintaining the balance of fluid, electrolytes and acid-base balance in the diuresis stage after kidney transplantation, therefore the traditional complex procedure can be simplified, and hyperglycemia caused by the traditional scheme can be also eliminated.