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Fluid resuscitation in acute pancreatitis: Normal saline or lactated Ringer's solution? 被引量:22
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作者 Michal Lipinski Alicja Rydzewska-Rosolowska +1 位作者 Andrzej Rydzewski Grazyna Rydzewska 《World Journal of Gastroenterology》 SCIE CAS 2015年第31期9367-9372,共6页
AIM: To investigate whether administration of Ringer's solution(RL) could have an impact on the outcome of acute pancreatitis(AP).METHODS: We conducted a retrospective study on 103 patients [68 men and 35 women,me... AIM: To investigate whether administration of Ringer's solution(RL) could have an impact on the outcome of acute pancreatitis(AP).METHODS: We conducted a retrospective study on 103 patients [68 men and 35 women,mean age 51.2 years(range,19-92 years)] hospitalized between 2011 and 2012. All patients admitted to the Department of Gastroenterology of the Central Clinical Hospital of the Ministry of Interior(Poland) with a diagnosis of AP who had disease onset within 48 h of presentation were included in this study. Based on the presence of persistent organ failure(longer than 48 h) as a criterion for the diagnosis of severe AP(SAP) and the presence of local complications [diagnosis of moderately severe AP(MSAP)],patients were classified into 3 groups: mild AP(MAP),MSAP and SAP. Data were compared between the groups in terms of severity(using the revised Atlanta criteria) and outcome. Patients were stratified into 2 groups based on the type of fluid resuscitation: the 1-RL group who underwent standard fluid resuscitation with a RL 1000 m L solution or the 2-NS group who underwent standard fluid resuscitation with 1000 m L normal saline(NS). All patients from both groups received an additional 5% glucose solution(1000-1500 m L) and a multi-electrolyte solution(500-1000 m L).RESULTS: We observed 64(62.1%) patients with MAP,26(25.24%) patients with MSAP and 13(12.62%) patients with SAP. No significant difference in the distribution of AP severity between the two groups was found. In the 1-RL group,we identified 22(55.5%) MAP,10(25.5%) MSAP and 8(20.0%) SAP patients,compared with 42(66.7%) MAP,16(24.4%) MSAP and 5(7.9%) SAP cases in the 2-NS group(P = 0.187). The volumes of fluid administered during the initial 72-h period of hospitalization were similar among the patients from both the 1-RL and 2-NS groups(mean 3400 m L vs 3000 m L,respectively). No significant differences between the 1-RL and 2-NS groups were found in confirmed pancreatic necrosis [10 patients(25%) vs 12 patients(19%),respectively,P = 0.637]. There were no statistically significant differences between the 1-RL and 2-NS groups in the percentage of patients who required enteral nutrition(23 patients vs 17 patients,respectively,P = 0.534). Logistic regression analysis confirmed these findings(OR = 1.344,95%CI: 0.595-3.035,P = 0.477). There were no significant differences between the 1-RL and 2-NS groups in mortality and the duration of hospital stay(median of 9 d for both groups,P = 0.776).CONCLUSION: Our study failed to find any evidence that the administration of RL in the first days of AP leads to improved clinical outcomes. 展开更多
关键词 ACUTE PANCREATITIs Fuid THERAPY lactated ringers
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Dynamics of vascular volume and hemodilution of lactated Ringer’s solution in patients during induction of general and epidural anesthesia 被引量:4
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作者 LI Yu-hong LOU Xian-feng BAO Fang-ping 《Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)》 SCIE CAS CSCD 2006年第9期738-744,共7页
Objective: To investigate the dynamics of vascular volume and the plasma dilution of lactated Ringer's solution in patients during the induction of general and epidural anesthesia. Methods: The hemodilution of i.v.... Objective: To investigate the dynamics of vascular volume and the plasma dilution of lactated Ringer's solution in patients during the induction of general and epidural anesthesia. Methods: The hemodilution of i.v. infusion of 1000 ml of lactated Ringer's solution over 60 min was studied in patients undergoing general (n=31) and epidural (n= 22) anesthesia. Heart rate, arterial blood pressure and hemoglobin (Hb) concentration were measured every 5 rain during the study. Surgery was not started until the study period had been completed. Results: General anesthesia caused the greater decrease of mean arterial blood pressure (MAP) (mean 15% versus 9%; P〈0.01) and thereby followed by a more pronounced plasma dilution, blood volume expansion (VE) and blood volume expansion efficiency (VEE). A strong linear correlation between hemodilution and the reduction in MAP (r=-0.50;P〈0.01) was found. At the end of infusion, patients undergoing general anesthesia retained 47% (SD 19%) of the infused fluid in the circulation, while epidural anesthesia retained 29% (SD 13%) (P〈0.001). Correspondingly, a fewer urine output (mean 89 ml versus 156 ml; P〈0.05) and extravascular expansion (454 ml versus 551 ml; P〈0.05) were found during general anesthesia. Conclusion: We concluded that the induction of general anesthesia caused more hemodilution, volume expansion and volume expansion efficiency than epidural anesthesia, which was triggered only by the lower MAP. 展开更多
关键词 HEMODILUTION Volume expansion ringer's solution General anesthesia Epidural anesthesia
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New method of local adjuvant therapy with bicarbonate Ringer’s solution for tumoral calcinosis: A case report
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作者 Takashi Noguchi Akio Sakamoto +1 位作者 Kensaku Kakehi Shuichi Matsuda 《World Journal of Orthopedics》 2024年第3期302-309,共8页
BACKGROUND Tumoral calcinosis is a condition characterized by deposits of calcium phosphate crystals in extra-articular soft tissues,occurring in hemodialysis patients.Calcium phosphate crystals are mainly composed of... BACKGROUND Tumoral calcinosis is a condition characterized by deposits of calcium phosphate crystals in extra-articular soft tissues,occurring in hemodialysis patients.Calcium phosphate crystals are mainly composed of hydroxyapatite,which is highly infilt-rative to tissues,thus making complete resection difficult.An adjuvant method to remove or resolve the residual crystals during the operation is necessary.CASE SUMMARY A bicarbonate Ringer’s solution with bicarbonate ions(28 mEq/L)was used as the adjuvant.After resecting calcium phosphate deposits of tumoral calcinosis as much as possible,while filling with the solution,residual calcium phosphate deposits at the pseudocyst wall can be gently scraped by fingers or gauze in the operative field.A 49-year-old female undergoing hemodialysis for 15 years had swelling with calcium deposition for 2 years in the shoulders,bilateral hip joints,and the right foot.A shoulder lesion was resected,but the calcification remained and early re-deposition was observed.Considering the difficulty of a complete rection,we devised a bicarbonate dissolution method and excised the foot lesion.After resection of the calcified material,the residual calcified material was washed away with bicarbonate Ringer’s solution.CONCLUSION The bicarbonate dissolution method is a new,simple,and effective treatment for tumoral calcinosis in hemodialysis patients. 展开更多
关键词 Tumoral calcinosis Adjuvant therapy BICARBONATE ringers solution sURGERY Case report
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6%羟乙基淀粉对CSEA患者围术期液体治疗的有效性和安全性评价
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作者 王建慧 《中国现代医生》 2009年第1期20-21,共2页
目的评价6%羟乙基淀粉(6%HES,200/0.5)预扩容的有效性和安全性。方法60例择期手术患者(ASAΙ~Ⅱ级,年龄20~60岁)随机分为6%HES组(H组)和复方乳酸钠组(R组),每组各30例,所有患者均采用CSEA。麻醉前30min以15mL(/kg.h)的速度输入6%HES... 目的评价6%羟乙基淀粉(6%HES,200/0.5)预扩容的有效性和安全性。方法60例择期手术患者(ASAΙ~Ⅱ级,年龄20~60岁)随机分为6%HES组(H组)和复方乳酸钠组(R组),每组各30例,所有患者均采用CSEA。麻醉前30min以15mL(/kg.h)的速度输入6%HES或复方乳酸钠溶液,输液1h后以50mL/h的滴速维持滴注。术中连续监测平均动脉压、心率、脉搏血氧饱和度,并于各时间点行动脉血气、酸碱平衡和电解质分析。结果扩容后R组MAP、HR和SpO2无明显改变,H组MAP明显上升。两组PH、HCO-3、BE于扩容后轻度下降(P<0.05),血浆Na+、K+、Ca2+无显著性差异,H组扩容后Hct、Hb下降,且H组比R组明显(P<0.05)。结论6%HES作为容量替代治疗用品是安全有效的,但是输入6%HES后可导致轻度的代谢性酸中毒,应予重视。 展开更多
关键词 羟乙基淀粉 复方乳酸钠 预扩容 代谢性酸中毒
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Effect of Ringer's Solution on Wear and Friction of Stainless Steel 316L after Plasma Electrolytic Nitrocarburising at Low Voltages 被引量:3
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作者 N.Afsar Kazerooni M.E.Bahrololoom +2 位作者 M.H.Shariat F.Mahzoon T.Jozaghi 《Journal of Materials Science & Technology》 SCIE EI CAS CSCD 2011年第10期906-912,共7页
A plasma electrolytic nitrocarburising (PEN/C) process was performed on stainless steel 316L to improve the surface properties for using as medical implants. A bath was optimised to reduce the required voltage to 15... A plasma electrolytic nitrocarburising (PEN/C) process was performed on stainless steel 316L to improve the surface properties for using as medical implants. A bath was optimised to reduce the required voltage to 150 volts. Aqueous urea-based solutions with 10% NH4Cl were prepared with slightly different amounts of Na2CO3 to optimise the electrolyte composition. The surface and the cross-section morphologies were studied by scanning electron microscopy. The microstructure and the chemical composition of samples were investigated by X-ray diffraction (XRD) and energy dispersive X-ray (EDX) techniques. The microstructure of the outer layer of the coatings was found to be a complex oxide containing Cr and Fe. The wear properties of the samples were examined by using a pin on disk wear test with Ringer's solution and were compared with their wear properties in the ambient atmosphere. The Ringe(s solution acted as a lubricant, reducing friction coefficient. Hardness and roughness were also studied. The bath with the composition of 10% NH4CI and 3% Na2CO3 exhibited the best tribological properties. The results showed that the tribological properties of treated samples were improved and the wear mechanism was abrasion of the pin. 展开更多
关键词 Plasma electrolytic nitrocarburising ringer's solution Tribological properties
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Plasma-Lyte 148: A clinical review 被引量:5
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作者 Laurence Weinberg Neil Collins +2 位作者 Kiara Van Mourik Chong Tan Rinaldo Bellomo 《World Journal of Critical Care Medicine》 2016年第4期235-250,共16页
AIM To outline the physiochemical properties and specific clinical uses of Plasma-Lyte 148 as choice of solution for fluid intervention in critical illness, surgery and perioperative medicine.METHODS We performed an e... AIM To outline the physiochemical properties and specific clinical uses of Plasma-Lyte 148 as choice of solution for fluid intervention in critical illness, surgery and perioperative medicine.METHODS We performed an electronic literature search from Medline and Pub Med(via Ovid), anesthesia and pharmacology textbooks, and online sources including studies that compared Plasma-Lyte 148 to other crystalloid solutions. The following keywords were used: "surgery", "anaesthesia", "anesthesia", "anesthesiology", "anaesthesiology", "fluids", "fluid therapy", "crystalloid", "saline", "plasma-Lyte", "plasmalyte", "hartmann's", "ringers" "acetate", "gluconate", "malate", "lactate". All relevant articles were accessed in full. We summarized the data and reported the data in tables and text. RESULTS We retrieved 104 articles relevant to the choice of Plasma-Lyte 148 for fluid intervention in critical illness, surgery and perioperative medicine. We analyzed the data and reported the results in tables and text.CONCLUSION Plasma-Lyte 148 is an isotonic, buffered intravenous crystalloid solution with a physiochemical composition that closely reflects human plasma. Emerging data supports the use of buffered crystalloid solutions in preference to saline in improving physicochemical outcomes. Further large randomized controlled trials assessing the comparative effectiveness of PlasmaLyte 148 and other crystalloid solutions in measuring clinically important outcomes such as morbidity and mortality are needed. 展开更多
关键词 surgery Anesthesia Fluid therapy CRYsTALLOIDs sALINE Plasma-Lyte Hartmann’s ringers ACETATE GLUCONATE lactate
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Influence of heat treatment on microstructure and electrochemical behaviors of Mg-Zn binary alloys prepared by gas-phase alloying technique 被引量:2
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作者 MA Jun NIU Li-bin +2 位作者 YAN Yu-ting GAO Chong WANG Xiao-gang 《Journal of Central South University》 SCIE EI CAS CSCD 2020年第3期762-771,共10页
Mg-Zn binary alloys fabricated by the gas-phase alloying technique under vacuum condition were investigated in the state of initial state and after heat treatment for the microstructure and electrochemical behaviors.D... Mg-Zn binary alloys fabricated by the gas-phase alloying technique under vacuum condition were investigated in the state of initial state and after heat treatment for the microstructure and electrochemical behaviors.Different from the traditional Mg-Zn alloys preparation methods,alloys prepared by gas-phase alloying have a large number of intermetallic compounds,such as MgZn,Mg7Zn3 and MgZn2.After solution treatment,the boundary of the eutectic disappeared and the size ofα-Mg increased from 100μm to 150μm.At the same time,the value of the resistance of charge transfer increased,which indicates that the resistance of the charge transfer and the corrosion resistance of the alloys increased.After artificial aging treatment,the distribution ofα-Mg was more uniform and its size was reduced to about 50μm,and there was new eutectic structure formed.The newly formed eutectic structure forms galvanic cells with the alloy matrix,which makes the corrosion resistance of the alloy weaken. 展开更多
关键词 gas-phase alloying Mg-Zn alloy heat treatment ringers solution electrochemical behavior
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Pyruvate-fortified resuscitation stabilizes cardiac electrical activity and energy metabolism during hypovolemia 被引量:3
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作者 Hunaid A Gurji Daniel W White +3 位作者 Besim Hoxha Jie Sun Albert H Olivencia-Yurvati Robert T Mallet 《World Journal of Critical Care Medicine》 2013年第4期56-64,共9页
AIM: To test the hypothesis that fluid resuscitation with Ringer's solution enriched with pyruvate(PR), a physiological antioxidant and energy substrate, affords protection of myocardial metabolism and electrophys... AIM: To test the hypothesis that fluid resuscitation with Ringer's solution enriched with pyruvate(PR), a physiological antioxidant and energy substrate, affords protection of myocardial metabolism and electrophysiological performance superior to lactated Ringer's(LR) during hypovolemia and hindlimb ischemia-reperfusion.METHODS: Male domestic goats(25-30 kg) were exsanguinated to a mean arterial pressure of 48 ± 1 mm Hg. Right hindlimb ischemia was imposed for 90 min by applying a tourniquet and femoral crossclamp. LR or PR, infused iv, delivered 0.05 mmol/kg per minute L-lactate or pyruvate, respectively, from 30 min hindlimb ischemia until 30 min post-ischemia. Time controls(TC) underwent neither hemorrhage, hindlimb ischemia nor resuscitation. Goats were sacrificed and left ventricular myocardium biopsied at 90 min fluid resuscitation(n = 6 per group) or 3.5 h later(n = 9 LR, 10 PR, 8 TC).RESULTS: Myocardial 8-isoprostane content, phosphocreatine phosphorylation potential, creatine kinase activity, and heart rate-adjusted QT interval(QTc) vari- ability were evaluated at 90 min resuscitation and 3.5 h post-resuscitation. PR sharply lowered pro-arrhythmic QTc variability vs LR(P < 0.05); this effect persisted 3.5 h post-resuscitation. PR lowered myocardial 8-isoprostane content, a product of oxidative stress, by 39 and 37% during and 3.5 h after resuscitation, respectively, vs LR. Creatine kinase activity fell 42% post-LR vs TC(P < 0.05), but was stable post-PR(P < 0.02 vs post-LR). PR doubled phosphocreatine phosphorylation potential, a measure of ATP free energy state, vs TC and LR(P < 0.05); this energetic enhancement persisted 3.5 h post-resuscitation.CONCLUSION: By augmenting myocardial energy state and protecting creatine kinase activity, pyruvateenriched resuscitation stabilized cardiac electrical function during central hypovolemia and hindlimb ischemiareperfusion. 展开更多
关键词 CREATINE kinase Electrocardiogram HYPOVOLEMIA 8-Isoprostane PHOsPHOCREATINE Reactive oxygen species ringers lactate
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乳酸林格液和BSS对白内障术后角膜内皮细胞密度和形态的影响(英文) 被引量:2
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作者 Farahdina Rahmawati Agus Supartoto +3 位作者 Wasisdi Gunawan Retno Ekantini Rinanto Prabowo Indra Tri Mahayana 《国际眼科杂志》 CAS 北大核心 2018年第2期207-212,共6页
目的:比较超声乳化过程中分别使用乳酸林格液和平衡盐溶液进行灌注,对角膜内皮细胞密度和形态的影响。方法:前瞻性随机对照研究于2017-02/2017-04期间在印度尼西亚日惹市Dr.YAP眼科医院进行。共有年龄相关性白内障患者52例52眼纳入了研... 目的:比较超声乳化过程中分别使用乳酸林格液和平衡盐溶液进行灌注,对角膜内皮细胞密度和形态的影响。方法:前瞻性随机对照研究于2017-02/2017-04期间在印度尼西亚日惹市Dr.YAP眼科医院进行。共有年龄相关性白内障患者52例52眼纳入了研究,分为两组,一组26例26眼术中使用乳酸林格液作为灌注液,另一组26例26眼使用平衡盐溶液作为灌注液。术后1、7和28d,评估角膜内皮细胞的密度和形态,同时比较两组患者眼内炎症反应情况。结果:纳入的全部52例52眼接受了超声乳化白内障摘除术联合人工晶状体植入。术后28d,平衡盐溶液组角膜内皮细胞减少了173.96/mm^2,较乳酸林格液组低(253.20/mm^2);角膜内皮细胞变异系数增加了2.92%,也较乳酸林格液组低(3.42%);六角形细胞百分比减少程度(4.30%)较乳酸林格液组(4.84%)低。平衡盐溶液组角膜中央厚度增加程度与林格液组相当(4.69μm vs 4.53μm)。两组角膜内皮细胞相关指标的差异均无显著性。两组之间炎症反应情况也相似。结论:平衡盐溶液和乳酸林格液在避免老年白内障患者超声乳化术后角膜内皮细胞丢失和形态改变方面效果相当。 展开更多
关键词 乳酸林格液 平衡盐溶液 超声乳化白内障摘除 年龄相关性白内障 角膜内皮细胞
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HSRP1携氧液对兔控制性重度失血性贫血早期灌注的疗效观察
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作者 游可为 刘嘉馨 +1 位作者 李剑波 王文刚 《中国输血杂志》 CAS 2022年第9期911-914,共4页
目的观察戊二醛聚合牛血红蛋白注射液(glutaraldehyde polymerizes bovine hemoglobin injection,代号:HSRP1)在兔重度失血性贫血早期灌注的疗效。方法建立兔控制性重度失血性贫血模型,将制模成功的12只兔分为HSRP1组和乳酸钠林格注射液... 目的观察戊二醛聚合牛血红蛋白注射液(glutaraldehyde polymerizes bovine hemoglobin injection,代号:HSRP1)在兔重度失血性贫血早期灌注的疗效。方法建立兔控制性重度失血性贫血模型,将制模成功的12只兔分为HSRP1组和乳酸钠林格注射液(sodium lactate ringer's injection,LR)组,每组6只,雌雄各半。HSPR1组和LR组分别用HSRP1和LR进行治疗。观察两组实验兔的存活率,并测量失血前后、灌注后24 h内各个时间点的血流动力学、静脉血气、血浆血红蛋白,以及碱剩余、乳酸和碳酸氢根等指标。结果HSRP1组实验兔存活率与LR组差异具有统计学意义(P<0.05);放血后,各组实验兔的平均动脉压显著降低,差异具有统计学意义(P<0.05),但在灌注后HSPR1组实验兔的平均动脉压与LR组差异无统计学意义;HSRP1组实验兔在灌注第二阶段,血液乳酸浓度和碱剩余在各时间点与LR组差异均存在统计学意义(P<0.05),在灌注后2 h时,呼吸频率与LR组差异均存在统计学意义(P<0.05),在灌注后4 h时心率与LR组相比,差异存在统计学意义(P<0.05);HSRP1组实验兔的血浆静脉氧分压、静脉氧饱和度和血浆血红蛋白在实验的各个时间点与LR组差异,均无统计学意义。结论HSPR1可用于兔重度失血性贫血,通过对缺氧组织供氧,纠正无氧代谢,提高实验兔的存活率。HSPR1作为一种新型携氧液,早期可纠正重度失血性贫血患者的氧供平衡。 展开更多
关键词 贫血 失血性贫血 戊二醛聚合牛血红蛋白 血红蛋白氧载体 乳酸钠林格液
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NaCl及Ringer氏液对东北林蛙精子活力的影响
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作者 蔡凤坤 巩振财 +4 位作者 张德文 张睿 刘凤霞 李卓 朴正吉 《北华大学学报(自然科学版)》 CAS 2013年第6期713-715,共3页
在实验室条件下,采用单因子试验方法研究不同浓度NaCl,Ringer氏液对东北林蛙精子活力的影响.结果表明:精子对NaCl的适宜质量分数范围为0.02%~0.25%,对Ringer氏液的适宜质量分数范围为0.03%~0.25%,最适Ringer氏液的质量... 在实验室条件下,采用单因子试验方法研究不同浓度NaCl,Ringer氏液对东北林蛙精子活力的影响.结果表明:精子对NaCl的适宜质量分数范围为0.02%~0.25%,对Ringer氏液的适宜质量分数范围为0.03%~0.25%,最适Ringer氏液的质量分数为0.09%~0.14%;试验组T1,T2,T3,T4和Tb,Tc,Td,Te精子的平均寿命及运动状态较其他组显示出显著优势;低浓度NaCl及Ringer氏液对林蛙精子有保护作用,且适宜浓度Ringer氏液对林蛙精子的保护作用大于NaCl. 展开更多
关键词 东北林蛙 精子活力 NACL ringer氏液
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碳酸氢钠林格液与复方氯化钠注射液治疗脓毒性休克的效果比较 被引量:2
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作者 郭卫东 高尚兰 姚童翔 《郑州大学学报(医学版)》 CAS 北大核心 2024年第1期87-91,共5页
目的:比较碳酸氢钠林格液、复方氯化钠注射液用于脓毒性休克的治疗效果。方法:选取2019年4月至2022年4月新乡市中心医院收治的脓毒性休克患者80例,分为A、B组,每组40例。A组接受碳酸氢钠林格液注射液限制性液体复苏,B组接受复方氯化钠... 目的:比较碳酸氢钠林格液、复方氯化钠注射液用于脓毒性休克的治疗效果。方法:选取2019年4月至2022年4月新乡市中心医院收治的脓毒性休克患者80例,分为A、B组,每组40例。A组接受碳酸氢钠林格液注射液限制性液体复苏,B组接受复方氯化钠注射液限制性液体复苏。比较两组患者复苏处理后0、1、3、6、12、24、48 h乳酸清除率,复苏第0、6、12、24、48 h电解质指标(K^(+)、Na^(+)、Cl^(-)),血流动力学恢复稳定时间(中心静脉压恢复时间、平均动脉压恢复时间),ICU住院时间,死亡率以及0、6、12、24、48 h快速序贯器官衰竭评分(qSoFA评分),48 h内所用液体总量,不良事件发生率。结果:0~48 h,两组乳酸清除率均呈升高趋势,A组高于B组(P<0.05)。两组不同时间点K^(+)、Na^(+)水平差异无统计学意义(P>0.05),Cl^(-)水平有随时间升高的趋势,且A组12、24、48 h Cl^(-)水平低于B组(P<0.05)。与B组相比,A组中心静脉压恢复时间、平均动脉压恢复时间、ICU住院时间更短,死亡率更低(P<0.05)。qSoFA评分有随时间降低的趋势,且A组12、24、48 h qSoFA评分低于B组(P<0.05)。A组48 h内所用液体总量少于B组(P<0.05)。两组不良事件发生率差异无统计学意义(P=0.644)。结论:碳酸氢钠林格液限制性液体复苏治疗脓毒性休克效果更好。 展开更多
关键词 碳酸氢钠林格液 复方氯化钠注射液 脓毒性休克 液体复苏
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碳酸氢钠林格液和复方林格液在控制性低中心静脉压肝切除术中的应用效果比较
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作者 米琰 白玉 +2 位作者 徐刚 李素芬 卢锡华 《新乡医学院学报》 CAS 2024年第5期438-442,共5页
目的探讨碳酸氢钠林格液和复方林格液对控制性低中心静脉压(CLCVP)肝切除术患者的酸碱平衡及肝肾功能的影响。方法选择2020年6月至2022年6月在郑州大学附属肿瘤医院行CLCVP肝切除术的60例原发性肝癌患者为研究对象,按随机数字表法将患... 目的探讨碳酸氢钠林格液和复方林格液对控制性低中心静脉压(CLCVP)肝切除术患者的酸碱平衡及肝肾功能的影响。方法选择2020年6月至2022年6月在郑州大学附属肿瘤医院行CLCVP肝切除术的60例原发性肝癌患者为研究对象,按随机数字表法将患者分为碳酸氢钠林格液组和复方林格液组,每组30例。在麻醉诱导后至肝实质离断前,碳酸氢钠林格液组患者输注碳酸氢钠林格液,复方林格液组患者输注复方林格液。分别于麻醉诱导前(T_(1))、手术开始时(T_(2))、术中2 h(T_(3))、术中4 h(T_(4))和手术结束时(T_(5)),使用血气分析仪检测2组患者的pH值、碱剩余(BE)、血乳酸(Lac)水平;分别于术前24 h和术后24 h使用全自动生化分析仪检测2组患者血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、血尿素氮(BUN)及血肌酐(Scr)水平;比较2组患者体质量、手术时间、术中输液量、尿量、手术过程中酸碱平衡变化及手术前后肝肾功能变化。结果2组患者体质量、手术时间、术中输液量及尿量比较差异均无统计学意义(P>0.05)。T_(1)时,2组患者pH值、BE、Lac水平比较差异无统计学意义(P>0.05);与T_(1)时比较,复方林格液组患者T_(2)时pH值升高,T_(3)~T_(5)时均降低,T_(2)~T_(5)的BE及Lac水平均升高(P<0.05);与T_(1)时比较,碳酸氢钠林格液组患者T_(2)时pH值显著升高,T_(3)时显著下降,T_(2)、T_(3)时BE及Lac水平均显著升高(P<0.05),T_(4)、T_(5)时pH值、BE、Lac水平与T_(1)时比较差异均无统计学意义(P>0.05);T_(5)时碳酸氢钠林格液组患者pH值显著高于复方林格液组,BE及Lac水平显著低于复方林格液组(P<0.05)。术前24 h,2组患者ALT、AST、BUN及Scr水平比较差异无统计学意义(P>0.05);2组患者术后24 h与术前24 h时的ALT、AST、BUN及Scr水平比较差异无统计学意义(P>0.05);术后24 h,2组患者的ALT、AST、BUN及Scr水平比较差异无统计学意义(P>0.05)。结论在CLCVP肝切除术中,相较于复方林格液,碳酸氢钠林格液对机体内环境的影响更小,可有效维持机体酸碱平衡稳定,且2种晶体溶液的使用均未对患者肝肾功能产生明显影响。 展开更多
关键词 控制性低中心静脉压肝切除术 原发性肝癌 碳酸氢钠林格液 复方林格液 酸碱平衡 肝肾功能
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阴离子交换色谱法同时测定乳酸钠林格注射液中乳酸钠和总氯含量
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作者 徐浩 朱静 +1 位作者 戴冬艳 陈剑秋 《中国药业》 CAS 2024年第20期76-78,共3页
目的建立同时测定乳酸钠林格注射液中乳酸钠和总氯含量的阴离子交换色谱法。方法分析柱为Dionex IonPac^(TM)AS11-HC柱(250 mm×4 mm),保护柱为AS11-HC柱(50 mm×4 mm),淋洗液为10 mmol/L氢氧化钾溶液,流速为1.0 mL/min,检测器... 目的建立同时测定乳酸钠林格注射液中乳酸钠和总氯含量的阴离子交换色谱法。方法分析柱为Dionex IonPac^(TM)AS11-HC柱(250 mm×4 mm),保护柱为AS11-HC柱(50 mm×4 mm),淋洗液为10 mmol/L氢氧化钾溶液,流速为1.0 mL/min,检测器温度为35℃,柱温为30℃,电导检测器,抑制器抑制电流为25 mA,进样量为25μL。结果乳酸根离子、氯离子质量浓度分别在9.97~249.37μg/mL、15.27~381.70μg/mL范围内与峰面积线性关系良好(r=0.9997,1.0000,n=6);精密度、稳定性、重复性试验结果的RSD均小于2.0%;平均加样回收率分别为100.74%,100.48%,RSD分别为1.17%,1.53%(n=9)。结论所建立的方法操作简便,灵敏度高,稳定性好,结果准确,可用于测定乳酸钠林格注射液中乳酸钠和总氯的含量。 展开更多
关键词 阴离子交换色谱法 乳酸钠 总氯 乳酸钠林格注射液 含量测定
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碳酸氢钠林格液与复方氯化钠注射液治疗脓毒性休克的疗效分析
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作者 韦方莹 王思媛 于秋雨 《系统医学》 2024年第15期70-73,共4页
目的 探究碳酸氢钠林格液、复方氯化钠注射液应用于脓毒性休克患者中的治疗效果。方法 回顾性选取2021年8月—2023年10月江苏省连云港市赣榆区人民医院接受限制性液体复苏治疗脓毒性休克患者70例的临床资料,按治疗方法分组,对比对照组(n... 目的 探究碳酸氢钠林格液、复方氯化钠注射液应用于脓毒性休克患者中的治疗效果。方法 回顾性选取2021年8月—2023年10月江苏省连云港市赣榆区人民医院接受限制性液体复苏治疗脓毒性休克患者70例的临床资料,按治疗方法分组,对比对照组(n=35,复方氯化钠注射液)与观察组(n=35,碳酸氢钠林格液)在乳酸清除情况、电解质平衡状态上的差异。结果 观察组用药后1、3、6 h乳酸测量值均较对照组低,差异有统计学意义(P均<0.05)。治疗后48 h观察组Cl-水平(106.23±3.17)mmol/L低于对照组(110.94±2.72)mmol/L,差异有统计学意义(t=6.671,P<0.05)。结论 在脓毒性休克的限制性液体复苏治疗之中,推荐选择碳酸氢钠林格液,相比复方氯化钠注射液可有效清除体内乳酸、维持水电解质平衡、预防功能衰竭,促使患者快速康复。 展开更多
关键词 碳酸氢钠林格液 复方氯化钠注射液 脓毒性休克 治疗效果
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醋酸钠林格液用于围术期容量治疗的随机对照临床研究 被引量:10
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作者 王昆鹏 白宇 +2 位作者 白涛 刘阳 王俊科 《沈阳药科大学学报》 CAS CSCD 北大核心 2011年第6期474-476,482,共4页
目的评价醋酸钠林格液用于围术期容量治疗的有效性和安全性。方法本研究为随机、对照、双盲研究。选择需要输液的择期手术患者80例,ASAⅠ~Ⅱ级,年龄18~65岁,随机分为2组(n=40),醋酸钠林格液组(AR组)和乳酸钠林格液组(LR组),病人建立... 目的评价醋酸钠林格液用于围术期容量治疗的有效性和安全性。方法本研究为随机、对照、双盲研究。选择需要输液的择期手术患者80例,ASAⅠ~Ⅱ级,年龄18~65岁,随机分为2组(n=40),醋酸钠林格液组(AR组)和乳酸钠林格液组(LR组),病人建立静脉通路后2 h内输注试验药或对照药2 L,作为血容量补充剂。观察生命体征的稳定性、血管活性药物的使用频次、酸碱和离子平衡以及血尿常规、肝肾功能和凝血功能等指标。结果各时间点收缩压、舒张压和心率,两组间比较差异无统计学意义(P>0.05);两组的血管活性药物的使用频次差异无统计学意义(P>0.05);治疗结束时两组收缩压稳定律的比较差异无统计学意义(P>0.05);给药后两组pH值与实际碱剩余(ABE)值变化差异有统计学意义(P<0.05)。结论醋酸林格注射液能有效用于围术期容量治疗,与乳酸钠林格注射液相比,其在维持血流动力学稳定及电解质平衡方面无显著性差异,但输注后pH值与ABE值高于乳酸钠林格液,用于治疗乳酸血症、酸中毒和缺氧或氧代谢异常者应更有优势。 展开更多
关键词 醋酸钠林格液 乳酸钠林格液 容量治疗
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醋酸钠林格液及乳酸钠林格液在小儿麻醉围手术期液体管理中的应用比较 被引量:11
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作者 陈政 付楚杰 +2 位作者 彭拓超 朱义 安频 《中国中西医结合急救杂志》 CAS CSCD 北大核心 2019年第1期113-116,共4页
目的观察醋酸林格液和乳酸林格液对1~6岁胫骨假关节联合矫治术患儿麻醉围手术期生命体征和血气分析等实验室检查指标的影响.方法选择湖南省儿童医院麻醉手术科2016年10月至2018年10月收治的64例全身麻醉复合连续硬膜外麻醉下行胫骨假关... 目的观察醋酸林格液和乳酸林格液对1~6岁胫骨假关节联合矫治术患儿麻醉围手术期生命体征和血气分析等实验室检查指标的影响.方法选择湖南省儿童医院麻醉手术科2016年10月至2018年10月收治的64例全身麻醉复合连续硬膜外麻醉下行胫骨假关节联合矫治术患儿,按随机数字表法将患儿分为乳酸钠林格液组(LR组)和醋酸钠林格液组(AR组),两组患儿分别给予相应晶体液用于术中维持.比较两组患儿手术开始前(T1)、手术开始2h(T2)、术毕(T3)生命体征及血气分析等实验室检查结果的差异.结果LR组最终完成研究22例,AR组最终完成研究28例.两组T1时动脉血二氧化碳分压(PaCO2)、Na^+、K^+、Ca^2+、血糖、血细胞比容(HCT)、碳酸氢根(HCO3^-)、总血红蛋白(THb)等实验室指标以及心率、收缩压、舒张压、体温等生命体征比较差异均无统计学意义(均P>0.05).T2、T3时AR组血乳酸(Lac)水平明显低于LR组(mmol/L:T2为1.01±0.21比1.42±0.47,T3为1.38±0.53比2.07±0.48,均P<0.05),pH值、碱剩余(BE)、HCO3^-均明显高于LR组〔pH值:T2为7.35±0.08比7.32±0.07,T3为7.33±0.06比7.28±0.03;BE(mmol/L):T2为1.02±0.18比0.67±0.45,T3为0.03±0.28比-0.01±0.57;HCO3^-(mmol/L):T2为21.28±1.20比20.10±0.17,T3为21.09±0.28比19.96±6.67,均P<0.05〕.结论在小儿先天性胫骨假关节联合矫形手术中输注醋酸钠林格液既可维持水、电解质和酸碱平衡及循环稳定,又可减少血Lac水平,有利于维持机体内环境的稳定. 展开更多
关键词 液体管理 骨科手术 醋酸林格液 乳酸林格液
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乳酸钠林格液和醋酸钠林格液复苏对失血性休克大鼠TNF-αIL-6和IL-10的影响 被引量:20
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作者 蔡腾 王振杰 +1 位作者 王林 孙凌江 《中国急救医学》 CAS CSCD 北大核心 2016年第2期166-170,共5页
目的比较醋酸钠林格液和乳酸钠林格液复苏失血性休克大鼠对其外周血及肝、肺组织TNF-α、IL-6、IL-10的影响。方法取24只SD大鼠,随机分成三组:休克不复苏组(NR组,n=8)、乳酸钠林格液组(LR组,n=8)和醋酸钠林格液组(AR组,n=8)... 目的比较醋酸钠林格液和乳酸钠林格液复苏失血性休克大鼠对其外周血及肝、肺组织TNF-α、IL-6、IL-10的影响。方法取24只SD大鼠,随机分成三组:休克不复苏组(NR组,n=8)、乳酸钠林格液组(LR组,n=8)和醋酸钠林格液组(AR组,n=8)。NR组、LR组及AR组制备成失血性休克模型(平均动脉血压维持40—45mmHg),LR组及AR组于休克后60min应用不同液体进行30min液体复苏,复苏后观察60min;NR组不予复苏。LR组及AR组休克前(TO)、休克后60min(T1)、复苏后30min(T2)、复苏后60min(T3)不同时间点取外周血,复苏后60min取大鼠肝、肺组织;NR组相应时间点采血,实验结束取肝、肺组织。ELISA法检测血液标本及肝、肺组织TNF-α、IL-6和IL-10含量。结果各组11D、T1及他时间点外周血IL-10含量均差异无统计学意义(P〉0.05),在仍时间点,NR组IL-10含量(36.50±0.82)比LR组(33.54±2.59)明显升高(P〈0.05)。各组哟、T1点外周血TNF-α、IL-6含量均差异无统计学意义(P〉0.05),在T2、B时间点,NR组TNF-α含量(172.03±7.13)、(180.57±6.70),IL-6含量(73.46±4.47)、(77.72±3.89)均高于LR组TNF-α含量(162.11±12.58)、(149.62±10.27),IL-6含量(68.17±4.85)、(64.71±5.39)及AR组TNF-α含量(162.73±10.59)、(146.16±10.70),IL-6含量(65.26±6.21)、(57.45±5.84),且LR组TNF-α、IL-6含量高于AR组(P〈0.05)。在大鼠肝肺组织中TNF-α、IL-6和IL-10含量,NR组比LR、AR组明显升高,且LR组TNF-α、IL-6也高于AR组(P〈0.05)。结论相比乳酸钠林格液,应用醋酸钠林格液复苏失血性休克大鼠能明显抑制外周血IL-6和肝肺组织TNF-α、IL-6的释放。醋酸钠林格液用于复苏早期失血性休克大鼠,其减轻全身炎症反应的效果可能优于乳酸钠林格液。 展开更多
关键词 失血性休克 液体复苏 乳酸钠林格液 醋酸钠林格液 炎性因子
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复方电解质洗涤回收红细胞对酸碱平衡和凝血功能的影响 被引量:11
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作者 汪玉林 陶国才 +2 位作者 石英 张超 邓玲 《临床麻醉学杂志》 CAS CSCD 北大核心 2010年第5期379-381,共3页
目的 观察复方电解质洗涤回收红细胞对红细胞携氧能力、酸碱平衡和凝血功能等的影响.方法 40例手术患者随机分为两组,每组20例,分别采用复方电解质注射液(A组)和复方乳酸钠(R组)回收自体血,检测血液回收前、输注完毕动脉血pH值、乳... 目的 观察复方电解质洗涤回收红细胞对红细胞携氧能力、酸碱平衡和凝血功能等的影响.方法 40例手术患者随机分为两组,每组20例,分别采用复方电解质注射液(A组)和复方乳酸钠(R组)回收自体血,检测血液回收前、输注完毕动脉血pH值、乳酸(Lac)、血氧饱和度50%时的氧分压(P50)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)和纤维蛋白原(Fib)浓度.结果 自体血输注后15 min,R组pH值较输注前降低(P〈0.05),R组Lac水平升高较A组更为显著(P〈0.05),R组P50值明显升高(P〈0.05).两组P50值与pH值输注前后变化有相关性(P〈0.05).输注后15 min两组PT、APTT较输注前均延长;Fib明显降低(P〈0.05).结论 复方电解质注射液洗涤回收红细胞有利于稳定酸碱平衡,防止血Lac水平升高,改善红细胞携氧能力,但对凝血功能的影响没有优势. 展开更多
关键词 复方电解质 复方乳酸钠 血液回收 P50 凝血功能
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几种不同液体复苏失血性休克大鼠的适宜量研究 被引量:11
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作者 李涛 刘良明 +3 位作者 刁有芳 廖自福 范小青 陈凤 《第三军医大学学报》 CAS CSCD 北大核心 2008年第3期199-202,共4页
目的对几种不同液体复苏失血性休克大鼠适宜量进行探讨。方法SD大鼠分别做35%、45%放血失血性休克模型,以不同量的乳酸林格液(LR)、羟乙基淀粉(HES)、高渗氯化钠右旋糖酐(HSD)和LR+HES进行复苏,观察其对失血性休克大鼠平均动脉血压(mean... 目的对几种不同液体复苏失血性休克大鼠适宜量进行探讨。方法SD大鼠分别做35%、45%放血失血性休克模型,以不同量的乳酸林格液(LR)、羟乙基淀粉(HES)、高渗氯化钠右旋糖酐(HSD)和LR+HES进行复苏,观察其对失血性休克大鼠平均动脉血压(mean arterial blood pressure,MAP)、左心室收缩压(left intraventricular systolic pressure,LVSP)、左心室压力上升或下降的最大速率(the maximal change rate of left intraventricular pressure,±dp/dtmax)的影响,同时观察血气指标变化和存活率的变化。结果在35%失血性休克(中度休克)时,不同剂量的LR、HSD输注对休克大鼠血流动力学的影响无显著差异(P>0.05);30ml/kg HES输液后血流动力学指标明显优于20ml/kg HES(P<0.05);1倍失血量LR+HES输注优于2倍和3倍失血量的LR+HES(P<0.05)。在45%失血性休克(重度休克)时,3倍失血量LR输液后血流动力学指标明显比1倍和2倍失血量的LR效果好(P<0.05);6ml/kg的HSD输注后血流动力学效果比4、8ml/kg的HSD效果好(P<0.05)。同样,30ml/kg HES和2倍失血量的LR+HES输液后改善血流动力学指标,血气指标和存活时间效果优于其他剂量组的HES和LR+HES(P<0.05),除HSD各剂量组明显降低血pH值外,其他各液体对血气指标的影响均不大。结论LR除复苏重度休克以3倍失血量输注效果好外,其余液体以HES30ml/kg,HSD6ml/kg以及2倍失血量的LR+HES复苏失血性休克效果较好,是较理想的失血性休克复苏容量。 展开更多
关键词 失血性休克 羟乙基淀粉 高渗氯化钠右旋糖酐
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