钠钾镁钙葡萄糖注射液对老年病人血乳酸、血糖及血气电解质变化的影响

摘要

目的：观察钠钾镁钙葡萄糖注射液(乐加)和乳酸钠林格氏液在老年病人术前急性血液稀释前后血乳酸、血糖及血气电解质的变化。方法：60例择期手术老年患者,ASAⅠ~Ⅱ,年龄65~83岁,随机分为乐加(L)组和乳酸钠林格氏液(R)组,每组各30例。入室后分别给予对应液体300ml静脉泵入,30min内输完,后按5ml/kg·h速度输注维持至手术结束。观察并记录输液前即刻(T0)、输液30min(T1)、60min(T2)及手术结束时(T3)动脉血乳酸、血糖及血气电解质变化情况。结果：两组患者年龄、体重及液体治疗前后血PH、PCO2、HCO3-、BE值均无显著性差异；R组内血乳酸浓度值在T1、T2及T3时点均较T0时点升高(P<0.05),L组内血乳酸浓度值各时点无显著性差异；两组间血乳酸浓度值在T0无显著性差异,R组在T1、T2及T3均较L组显著升高(P<0.05)。两组内血糖浓度值在T1、T2及T3均较T0升高(P<0.05)；两组间血糖浓度值在T0比较无显著性差异,L组在T1、T2及T3均较R组略升高,差异无统计学意义。两组内(Na+)、(K+)及(Ca2+)在T1、T2及T3均较T0降低(P<0.05)；两组间比较无显著性差异。两组内(Mg2+)在T1、T2及T3均较T0下降(P<0.05)；两组间(Mg2+)在T0比较无显著性差异,R组在T1、T2及T3均较L组下降更显著(P<0.05)。结论：应用钠钾镁钙葡萄糖注射液与乳酸钠林格氏液对老年患者行液体治疗时都是安全有效的,与乳酸钠林格氏液比,钠钾镁钙葡萄糖注射液可为老年患者提供更稳定的内环境。%Objective:To compare the effects of sodium potassium magnesium calcium and glucose injection and lactated Ringer's solution on blood lactic acid,blood glucose,arterial blood gas and electrolytes in old patients during the operation.Methods:Sixty ASAⅠ~Ⅱage from 65~83 years old patients undergoing elective operation were randomly allocated into 2 groups(n=30 for each):received lactated Ringer's solution and sodium potassium magnesium calcium and glucose injection group:received sodium potassium magnesium calcium and glucose injection.The blood lactic acid,blood glucose,arterial PH,PCO2,HCO3-,BE,Hct,Hb and electrolytes were measured at the time of the solution infusing(T0),after the solution infusing 30min(T1),60min(T2)and the end of surgery(T3).Results:The age,weight and PH,PCO2, HCO3-,BE had no significance in two groups.Lactic acid and glucose of group R increaser at T1,T2,T3 than T0(P<0.05).Glucose in group L increaser at T1,T2,T3 than T0 but lactic acid in group L has no significance difference at any time.Lactic acid in group R increaser than group L at T1,T2 and T3(P<0.05),and glucose in group L slightly increaser than group R.(Na+),(K+),(Ca2+)and (Mg2+) were lower at at T1,T2,T3 than T0 in two groups(P<0.05).(Na+),(K+)and (Ca2+) had no significant difference between two groups.(Mg2+)has no obvious difference at T0 between two groups,bue (Mg2+) in group R was lower than group L at T1,T2 and T3 (P<0.05).Conclusion:The use of sodium potassium magnesium calcium and glucose injection and sodium lactate ringer injection to do fluid treatment for old patients were safe and effective,sodium potassium magnesium calcium and glucose injection could offer more steadily internal environment for old patients than sodium lactate ringer injection.