肾移植术中补液与移植后新发糖尿病的应用研究

Study on infusion using in renal transplantation and the influence on NODAT

目的探讨肾移植术中不同输液种类对患者移植后新发糖尿病的影响，了解移植流程输液的最佳效果。方法将80例肾移植患者随机分为氯化钠组和对照组，每组40例，氯化钠组采用0．9％氯化钠溶液为流程输液．对照组采用5％葡萄糖液为流程输液，对两组患者围术期血糖、糖化血红蛋白、血钠值及胰岛素应用，术中开放循环后肾脏快速泌尿时间及量，术后1—5 d尿量进行比较分析。结果氯化钠组血糖、血钠值变化，胰岛素应用，术后多尿期肾小管浓缩功能均优于对照组，四项观测指标均具有统计学意义（P〈0．05），两组患者糖化血红蛋白及开放循环后肾脏快速泌尿时间及量没有明显差异（P〉0．05）。结论 肾移植术中采用0．9％氯化钠溶液为流程输液，有利于术中血钠、血糖平稳及减少胰岛素应用，对降低移植后暂时性新发糖尿病的发生有一定作用。

[Objective] To evaluate the influence of different kinds of infusion on new onset diabetes after transplantation （NODAT） in renal transplant recipients, to find the best results of infusion using in thetreatment process. [Methods] 80 patients with renal transplantations were randomly divided into A （test）, B（control） group, n =40. A group used 0.9% sodium chloride brine in the treatment process. B group used 5%glucose solution in the treatment process. Then, to compare and analysis the two groups blood glucose,HbAlc, serum sodium, application of insulin and the time and amount of renal urinary after opening renalcirculation and the urinary volume from 1 to 5 days after renal transplantation. [Results] The changing ofblood glucose, serum sodium, the application of insulin and the concentrating ability of renal tubular in allure-sis stage after renal transplantation in the test group were better than the control group. The four clinical in-dicators were statistically significant （P〈0.05）. There were no significant difference in the HbAlc and the timeand amount of renal urinary of the two groups after opening renal circulation （P 〉0.05）. [ Conclusion] Using0.9% sodium chloride brine in the treatment process of renal transplantation is beneficial for the steady ofblood glucose and serum sodium, and will reduce the application of insulitt, and has specific effect on reduc-ing the new onset diabetes after transplantation （NODAT）.