静脉泵注肾上腺素在胃癌根治手术中对血钾的影响

Effect of vein pump injection of epinephrine on serum potassium during gastric cancer radical surgery

目的观察静脉泵注肾上腺素在胃癌根治手术中对血钾的影响。方法纳入40例ASA分级Ⅱ~Ⅲ级,拟在全麻下择期行胃肠道手术的患者,随机分为试验组和对照组,试验组患者持续静脉泵注肾上腺素0.03~0.1μg/(kg·min),对照组患者则泵注同等剂量的生理盐水。监测并比较两组患者在不同时间点血钾浓度的变化。结果试验组与对照组在性别构成及年龄分布上差异未见统计学意义(P>0.05)。与对照组相比,肾上腺素泵注30 min即T_3时刻患者血钾下降差异有统计学意义(P<0.05),且低于试验组的T_1时间点(P<0.05);与对照组相比,停止泵注肾上腺素10 min即T_4时间点血钾升高差异有统计学意义(P<0.05),且高于试验组的T_1时间点(P<0.05);与对照组相比T5时间点血钾浓度依然较高,差异有统计学意义(P<0.05),且高于试验组的T_1时间点(P<0.05)。结论静脉泵注肾上腺素在胃肠道手术中会降低血钾浓度,停止肾上腺素泵注血钾升高,并且高于基础值。

Objective To investigate vein pump injection of epinephrine on the effect of serum potassium during gastric cancer radical surgery. Method Forty patients with ASA grade Ⅱ~Ⅲ underwent surgery within a time limit of gastrointestinal under general anesthesia. All patients were randomly divided into the experimental group and the control group.Patients in the experimental group received continuous intravenous injections of adren-aline[0.03 to 0.1 μg/（kg·min）].Patients in the control group received equal dose of saline.Potassium concentra-tions at different time points were determined and compared between patients in two groups. Results No signifi-cant differences were observed in gender and age distribution of patients in the experimental group and the control group. Compared with the control group,potassium concentration was significantly decreased in patients at T3mo-ment（30 min pump injection of norepinephrine）（P〈0.05）,but was lower than that of patients in the experimen-tal group at T1moment（before anesthesia）（P〈0.05）.Compared with the control group,potassium concentration was significantly increased in the experimental group at T4moment（pump adrenaline injection for 10 min）（P 〈0.05）,which was also significantly higher than that in the experimental group at T1moment（P 〈 0.05）. Mean-while,compared with the control group,potassium concentration was also significantly increased in the experimen-tal group at T5moment（stop the pump adrenaline injection for 30 min）,which was also significantly higher than that in the experimental group at T1moment（P 〈 0.05）. Conclusions Intravenous injection of adrenaline can reduce potassium concentration in patients received gastrointestinal surgery,and potassium concentration can be increased after adrenalin injection was stopped.