普外科病人术后低磷血症发生和防治的临床研究

The clinical study of prevalence,prevention and treatment of hypophosphatemia in postoperative patients of general surgery.

目的 探讨普外科病人术后低磷血症的发生率 ,补磷的时机、剂量及其在术后康复中所起的作用。方法 检测补磷组和无补磷组病人术前及术后第 1、3、5、7天的血磷浓度。结果 未补磷组术后 91 1%的病例发生低磷血症 ,补磷组术后 5 7 8%的病例发生低磷血症。补磷组补磷后 (术后第 3、5、7天 )的血磷浓度均较同时期未补磷组的为高 (P <0 0 0 1,P <0 0 5 ,P <0 0 1) ;补磷组补磷前后ApacheⅡ评分均值比较有降低 (P <0 0 0 1)。结论 术后补磷可有效地纠正普外科病人术后低磷血症的发生 ,改善ApacheⅡ评分。

Objective In order to explore the prevalence of hypophosphatemia in postoperative patients of general surgery,as well as the time and dosage of phosphate replacement and its effects.Methods To serum phosphate levels of 45 patients with phosphate replacement begun on the second postoperative day and 45 without replacement were monitored at the preoperative day,and the first,third,fifth and seventh postoperative day.Results The incidence of hypophosphatemia was 91 1%(41/45) in cases without phosphate replacement.While it was 57 8%(26/45) in those with replacement.The serum phosphate concentrations in cases with phosphate replacement were higher than those without replacement on the third(P<0 001),fifth(P<0 05) and seventh(P<0 01) postoperative day.The Apache Ⅱ scores in cases with phosphate replacement decreased on the third postoperative days compared with those on the first day(P<0 001).Conclusion The postoperative replacement of phosplates can avert the occurrence of hypophosphatemia and improve the Apache Ⅱ score.