吴 昊.转化糖电解质注射液在围手术期中的输注速度与血糖波动关系[J].肿瘤学杂志,2015,21(10):848-851.
转化糖电解质注射液在围手术期中的输注速度与血糖波动关系
Relationship Between Infusion Speed and the Level of Blood Glucose of Multiple Electrolytes and Invert Sugar Injection During Preoperative Period
投稿时间:2015-03-15  
DOI:10.11735/j.issn.1671-170X.2015.10.B014
中文关键词:  转化糖电解质注射液  血糖  胰岛素
英文关键词:multiple electrolytes and invert sugar injection  blood glucose  insulin
基金项目:
作者单位
吴 昊 浙江省肿瘤医院 
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中文摘要:
      摘 要:[目的] 观察转化糖电解质注射液在围手术期中的输注速度与血糖波动的关系,为转化糖电解质注射液的合理化临床输注速度及用量提供科学依据。[方法] 选取60例行下腹部手术的患者,随机分为三组,A组复方氯化钠注射液500ml组,B组5%转化糖电解质注射液500ml组(0.4g/kg/hr以果糖计),C组5%转化糖电解质注射液500ml组(0.6g/kg/hr以果糖计)。分别于开始输注液体前0min(T0)、输注液体后15min(T1)、30min(T2)、60min(T3)抽取动脉血,观察三组患者的平均动脉压、心率、麻醉指数、血糖浓度、胰岛素浓度、电解质及pH。[结果]三组患者在T0~T3时刻平均动脉压、心率、麻醉指数比较差异均无统计学意义(P>0.05)。在T0时刻,三组血糖和胰岛素浓度比较差异无统计学意义(P>0.05);在T1~T3时刻,A组血糖和胰岛素浓度均低于B、C组,差异有统计学意义(P<0.05),并且B组血糖和胰岛素浓度小于C组,差异有统计学意义(P<0.05)。三组电解质浓度在T0~T3时刻比较差异无统计学意义(P>0.05);pH值在T0、T1时刻三组比较差异无统计学意义,在T1、T2时刻,A组pH值大于B、C组,差异有统计学意义(P<0.05),并且B组pH值大于C组,差异有统计学意义(P<0.05)。[结论] 转化糖电解质注射液具有升高血糖的作用,且该作用受输注速度影响,在一定范围内,输注速度越快血糖上升越明显。转化糖电解质注射液对机体电解质浓度影响较小,对pH值稍有影响。为安全起见,宜将对溶液的输注速度控制在0.4g/kg/hr(以果糖计)以内。
英文摘要:
      Abstract:[Purpose] To investigate the relationship between the infusion speed and the level of blood glucose of multiple electrolytes and invert sugar injection during preoperative period.[Methods] Sixty patients undergoing elective lower abdomen surgery were randomly divided into three groups:Group A(sodium lactate ringer’s injection group),Group B[multiple electrolytes and invert sugar injection group(0.4g/kg/hr by fructose)] and Group C[multiple electrolytes and invert sugar injection group(0.6g/kg/hr by fructose)]. Before infusion (T0) and 15min(T1),30min(T2),60min(T3)after infusion,MAP,HR,BIS,glucose,insulin,electrolytes and Ph were observed.[Results] The three groups had no statistically significant difference of MAP,HR,BIS at T0~T3(P>0.05).The glucose and insulin of three groups had no statistically significant difference at T0(P>0.05).At T1~T3,the glucose and insulin of group A were smaller than those of group B and C,with significant difference(P<0.05),and group B was smaller than those of group C(P<0.05). The electrolytes of three group had no statistically significant difference(P>0.05).pH of three group had no statistically significant difference at T0~T1(P>0.05),while at T2~T3,pH of group A was higher than that of group B and C(P<0.05),and pH of group B was higher than that of group C(P<0.05).[Conclusions] The multiple electrolytes and invert sugar injection can raise the level of blood glucose,and it is affected by infusion speed.The multiple electrolytes and invert sugar injection have little influence on K+,Na+ and have influence on pH.To be safe,the infusion speed of multiple electrolytes and invert sugar injection should be limited within 0.4g/kg/hr(by fructose).
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