Liu Xiang,Cao Hongyan,Qiao Li,et al.Effects of acetated Ringer’s solution on acid-base balance and electrolytes in biliary atresia children[J].Journal of Clinical Pediatric Surgery,2020,19(06):503-507.[doi:10.3969/j.issn.1671-6353.2020.06.008]
醋酸钠林格液对围手术期胆道闭锁患儿酸碱平衡和电解质的影响
- Title:
- Effects of acetated Ringer’s solution on acid-base balance and electrolytes in biliary atresia children
- 分类号:
- R977.7;R722;R575.7;R725.7
- 摘要:
- 目的 评价醋酸钠林格注射液对围手术期胆道闭锁（Biliary Atresia，BA）患儿血乳酸和电解质的影响。方法 选择2017年1月至2018年12月河北医科大学附属河北省儿童医院在全身麻醉下行Kasai术的60例BA患儿作为研究对象，手术日龄21~65 d，ASA分级Ⅱ或Ⅲ级，随机分为乳酸钠林格注射液组（n=30）和醋酸钠林格注射液组（n=30）。根据Holliday和Segar公式输液原则进行围术期液体治疗。分别于切皮前（T1）、手术结束时（T2）和术后12 h时（T3）3个时间点检测并记录静脉血Na+、K+、HCO3-、Cl-、Ca2+、血糖、乳酸浓度和pH值。术中监测体温，并记录术中血管活性药物应用和低血糖发生情况。术后统计失血量、输液量和尿量。结果 两组患儿失血量、输液量和尿量差异无统计学意义（P>0.05），术中血管活性药物应用和低血糖发生情况比较差异无统计学意义（P>0.05）。与乳酸钠林格注射液组比较，T2时点醋酸林格注射液组乳酸浓度降低（P<0.05）；与T3时点比较，醋酸钠林格注射液组和乳酸钠林格注射液组T1、T2时点体温降低（P<0.05）。结论 醋酸钠林格液可以用于Kasai手术患儿术中液体治疗，可维持机体电解质和酸碱内环境的稳定。
- Abstract:
- Objective To evaluate the efficacy of sodium acetate ringer on fluid therapy in biliary atresia (BA) children.Methods A total of 60 children aged 21 to 65 days,American Society of Anesthesiologists physical statusⅡ/Ⅲ,scheduled for elective Kasai surgery under general anesthesia were randomized divided into LR:sodium lactate ringer’s injection group and AR:sodium acetate ringer’s injection group(n=30 each).The concentrations of sodium ion,potassium ion,bicarbonate ion,chorine ion,calcium ion and lactate and pH values were recorded at the timepoints of pre-skin incision (T1),end of surgery (T2) and postoperative 12 h (T3).Intraoperative body temperature was monitored,and intraoperative vasoactive agents and hypoglycemia were recorded.Postoperative blood loss,transfusion volume and urine volume were counted.Results No significant inter-group statistical difference existed in volume of blood loss,transfusion volume,volume of urine,intraoperative use of vasoactive agents or occurrence of hypoglycema (P>0.05).As compared with LR:sodium lactate ringer’s injection group,lactae concentration was significantly lower in group AR:sodium acetate ringer’s injection group at T2 (P<0.05); as compared with T3,the temperatures of both groups decreased at T1 and T2 (P<0.05).Conclusion Acetated Ringer may be a feasible and effective alternative for maintaining the in vivo balances of electrolytes and acid-base during pediatric Kasai surgery.
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备注/Memo
收稿日期:2019-05-10。
通讯作者:石磊,Email:shileilx@163.com