摘要目的 比较术中输入复方氯化钠注射液、乳酸林格注射液、醋酸钠钾镁钙葡萄糖注射液对酸碱平衡及电解质的影响.方法 胃癌根治术患者48例,按随机数字表法分为复方氯化钠注射液组(N组)、乳酸林格注射液组(L组)、醋酸钠钾镁钙葡萄糖注射液组(A组),每组16例.N组术中输入复方氯化钠注射液,L组输入乳酸林格注射液,A组输入醋酸钠钾镁钙葡萄糖注射液,输入胶体液均为羟乙基淀粉130/0.4氯化钠注射液.观察诱导前,诱导后1、2、3、4hpH值、K+浓度、Ca2+浓度、Na+浓度、血乳酸(LAC)值、血糖(GLU)值、血液碱剩余(BE)值变化.结果 3组患者在年龄、性别、身高、体重、ASA分级、手术时间、麻醉时间、术中输入晶体量、术中输入胶体量、出血量、尿量共计11项指标差异均无统计学意义(P＞0.05).所有患者入室后GLU均升高,组间比较差异无统计学意义(P＞0.05).T1、T2、T3、T4各时间点A组Ca2+浓度比L组分别提高14.30、9.43、9.84、10.92％(P＜0.05)；T1、T2、T3各时间点A组Ca2+浓度比N组分别提高12.86、8.53、6.26％(P＜0.05).L组LAC值在T2时间点较To提高33.3％(P＜0.05).结论 胃癌根治术中输注醋酸钠钾镁钙葡萄糖注射液不会引起血乳酸盐水平增高.输注醋酸钠钾镁钙葡萄糖注射液有利于维持血浆Ca2+浓度稳定.

abstractsObjective To compare the effects of infusing Sodium Potassium Magnesium Calcium and Glucose Injection,Ringers solution and Lactated Ringers solution on acid/base balance during operation.Methods 48 patients undergoing radical gastrectomy were divided equally into 3 groups randomly (n=16):the lactated Ringers group (group L),the Ringers solution group (group N) and Sodium potassium magnesium calcium and glucose injection group(group A).The lactated Ringers solution was given in group L and the Ringers solution in group N,Sodium potassium magnesium calcium and glucose injection was given in group A.Neither groups are cross-given other crystal solution during potation,Voluven was the colloid solution in both groups.Changes of lactate and gas before and 1,2,3,4 h after induction respectively were observed.Results There was no statistics difference in the age,sex,stature,weight,ASA grade,operation time,anesthesia time,the volume of transfusion during operation,hemorrhage and urine volume etc of both groups (P＞0.05).The glucose level increased significantly 60 min after anesthesia in both groups,but there was no statistics difference between the three groups (P＞0.05).Calcium concentration in group A increased by 14.30,9.43,9.84,10.92％ at time point of T1,T2,T3,T4 respectively compared to group L (P＜O.05).Calcium concentration in group A increased by 12.86,8.53,6.26％ at time point of T1,T2,T3 respectively compared to group N(P＜0.05).Serum lactate level increased 33.3％ at T2 compared to To time point in Group L (P＜0.05).Conclusions Sodium Potassium Magnesium Calcium and Glucose solution does not increase serum lactate level in gastrectomy.We found this solution had benefits in maintaining serum calcium level.