3%高渗盐水对颅脑手术患者动脉血钾的影响

Effect of 3% hypertonic saline on plasma kalium in patients undergoing neurosurgery

目的观察3%高渗盐水对颅脑手术患者动脉血气、术中补液量及尿量的影响。方法将70例年龄18~65岁颅脑手术患者分为对照组(45例)和浓钠组(25例),记录切开硬脑膜前脑膜张力的情况,在手术开始前(T0)及手术结束后(T1)抽取动脉血行血气分析,记录患者术中补液量、尿量和出血量。结果浓钠组患者切开硬脑膜前脑膜张力中级以上患者明显增多,动脉血钾明显增高,差异有统计学意义(P<0.01)。两组患者动脉血糖均明显增高(P<0.01)。两组患者动脉血钠、动脉血p H和CO_2分压、乳酸、补液量、尿量和出血量比较,差异无统计学意义(P>0.05)。结论 3%高渗盐水有增加颅脑手术患者动脉血钾水平的倾向。

Objective To investigate 3% hy Pertonic saline on arterial blood gas,fluid infusion and urine output in Patients undergoing neurosurgery. Methods Seventy Patients aging 18 to 65 undergoing neurosurgery were divided into control group（ n = 45） and 3% hypertonic saline-treated group（ n = 25）. Intracranial Pressure before the incision of decameter,arterial blood gas analysis at the beginning（ T0） and the end（ T1） of surgery,fluid infusion,urine output and blood loss were recorded. Results In 3% hypertonic saline-treated group,intracranial pressure of more patients reached moderate and good degree of satisfaction（ P〈0. 01）,and Plasma kalium of patents increased significantly（ P〈0.01）. In both groups,plasma glucose raised sharply（ P〈0.01） while plasma natrium,PH,carbon dioxide tone,lactate,fluid infusion,urine output and blood loss had no obvious difference in this two groups（ P〈0.05）. Conclusions 3% hypertonic saline has a tendency to increase the level of arterial blood potassium in patients with craniocerebral operation.