不同晶体液对胃肠道手术婴儿电解质、血糖的影响

Effects of Different Crystalloids on Electrolytes and Blood Glucose in Infants Undergoing Gastrointestinal Surgery

目的比较生理盐水、2.5%葡萄糖生理盐水及复方电解质液对婴儿胃肠道手术电解质、血糖的影响,探讨婴儿的胃肠道手术输入何种液体更为合适。方法选择我院行胃肠道手术的婴儿60例,随机分为等张的生理盐水组(C组),1/2张2.5%葡萄糖生理盐水组(G组)及等张的复方电解质液组(F组)3组,每组20例。手术期间各组患儿的输液按各实验分组的方案进行。各组患儿均于静脉输液前(T_0)、静脉输液30 min(T_1)、静脉输液60 min(T_2)、静脉输液90 min(T_3)及静脉输液120 min(T_4)时记录HR及MAP的变化;并在上述各时间点抽取桡动脉血测血Na^+、Cl^-、K^+、Glu;术后2 h(T5)再抽血测定一次Glu(术后2 h内仍输注围术期的同种液体)。结果与T0时比较,T_3、T_4时G组Na^+、K^+值降低(P<0.05);T_4时G组Cl^-值降低(P<0.05);T_2、T_3、T_4时C组Cl^-值升高(P<0.05);T_2、T_3、T_4时C组与F组的Glu值升高(P<0.05);T5时C组与F组的Glu值降低(P<0.05);而T_1、T_2、T_3、T_4、T5时G组的Glu值持续升高(P<0.05)。与C组比较,T_2、T_3、T_4时G组Na+值、G组和F组Cl-值低于C组(P<0.05);T_3、T_4时G组K+值低于C组(P<0.05)。与G组比较,T_3、T_4时F组Na^+、K^+值高于G组(P<0.05);T_4时F组Cl-值高于G组(P<0.05)。T_2、T_3、T_4、T_5时C组、F组的Glu值低于G组(P<0.05)。结论在婴儿的胃肠道手术中输注复方电解质液更为理想。

Objective To compare the effects of normal saline,2.5%glucose saline and compound electrolyte on electrolyte and blood glucose in infants'gastrointestinal surgery,and to explore which fluid is more suitable for gastrointestinal surgery.Methods 60 infants underwent gastrointestinal surgery in our hospital were randomly divided into isotonic saline group(group C),1/2 2.5%glucose saline group(group G)and isotonic compound electrolyte group(Group F).Three groups of 20 cases each.The infusions of the children in each group during the operation were performed according to the protocol of each experimental group.HR and MAP were recorded in all groups before venous infusion(T0),intravenous infusion for 30 min(T1),intravenous infusion for 60 min(T2),intravenous infusion for 90 min(T3),the changes of HR and MAP were recorded at 120 min(T4).At the above time points,blood was taken from the brachial artery to measure Na^+,Cl^-,K^+and Glu.After 2 h(T5),the blood was measured again.(The same type of perioperative fluid was still infused within 2 h after surgery).Results Compared with T0,the values of Na^+and K^+in group G decreased at T3 and T4(P<0.05).The values of Cl^-in group G decreased at T4(P<0.05).The values of Cl^-in group C increased at T2,T3 and T4(P<0.05);Glu values of group C and group F increased at T2,T3 and T4(P<0.05);Glu values of group C and group F decreased at T5(P<0.05);The Glu values of G group continued to increase at T1,T2,T3,T4 and T5(P<0.05).Compared with group C,the Na^+value of G group,the Cl^-value of G group and F group were lower than that of C group at T2,T3 and T4(P<0.05).The K^+value of G group was lower than that of C group at T3 and T4(P<0.05).Compared with group G,the values of Na^+and K^+in group F were higher than those in group G at T3 and T4(P<0.05).The value of Cl^-in group F was higher than that in group G at T4(P<0.05).The Glu values of group C and group F were lower than those of group G at T2,T3,T4 and T5(P<0.05).Conclusion It is more ideal to infuse a compound electrolyte in gastrointestinal surgery in infants.