新生儿坏死性小肠结肠炎术中液体治疗观察

Intraoperative fluid therapy in neonatal necrotizing enterocolitis

目的比较术中应用钠钾镁钙葡萄糖注射液和氯化钠注射液2种液体对新生儿坏死性小肠结肠炎(NEC)预后的影响。方法选取出生30周以上患有新生儿坏死性小肠结肠炎行开腹探查术的患儿28例,手术时间不超过2 h。随机分为钠钾镁钙葡萄糖注射液组(L组)及传统的氯化钠注射液组(N组),2组均采用吸入七氟醚全身麻醉,分别于输液即刻(T_0)、手术开始后1 h(T_1)与手术结束时(T_2)测定患儿动脉血气,观察患儿电解质、血糖和乳酸值变化。结果 L组输注前后血糖无明显变化,N组血糖下降明显,但仍在正常值范围内,且L组血乳酸浓度值较N组明显下降。结论钠钾镁钙葡萄糖注射液能够维持新生儿围手术期正常的能量需求及电解质平衡,可能是NEC患儿更为有效、理想的液体选择。

Objective To compare the outcome of intraoperative administration of sodium potassium magnesium calcium and glucose intravenous fluid versus normal saline intravenous fluid on the prognosis of neonatal necrotizing enterocolitis （ NEC） . Methods A total of 28 children with neonatal necrotizing enterocolitis who underwent laparotomy were enrolled in this study. 2 hours. They were randomly divided into Lejia intravenous group （ L group） and the traditional normal saline intravenous group（N group）. Both groups were anesthetized with inhalational sevofurane. Arterial blood gas,blood ured at the points of right before starting infusion （ T0 ）,1 h after operation （ T1 ） and at the end of significant change in blood glucose between before and after infusion in group L,but the blood glucose but still within the normal range. Blood lactic acid in group Lwas significantly lower than that in group N. Conclusion Lejia intravenous fluid can maintain normal energy demand and electrolyte balance during the perioperative period of neonates,which may be a more effec-tive and ideal fluid replacement choice for NEC children.