术中输入乳酸钠林格液及醋酸钠林格液对血乳酸盐及酸碱平衡影响.docVIP

术中输入乳酸钠林格液及醋酸钠林格液对血乳酸盐及酸碱平衡影响 　【摘要】 目的 比较术中输入乳酸钠林格液和醋酸钠林格液血乳酸盐及血气的变化。方法 40例择期手术患者按随机数字表随机分为乳酸钠组（L组）和醋酸钠组（A组），每组各20例，采用静吸复合全身麻醉。L组术中输入乳酸钠林格液，A组术中输入醋酸钠林格液，两组术中不交叉输入其他晶体液，输入胶体液均为菲克血隆（内含聚明胶肽）。观察诱导前，诱导后1h、2h、3h及4h的血乳酸盐、SpO2、PETCO2、呼末异氟醚浓度、呼末N2O浓度、MAC及血气变化。 结果 两组在年龄、性别、身高、体重、ASA分级、手术时间、麻醉时间、术中输液量、出血量、尿量等方面均差异无 显著性（Pgt;0.05）。乳酸盐正常值为0.50～2.22mmol/L。两组诱导前、诱导后1h、2h、3h、4h的血乳酸盐、SpO2、PETCO2、呼末异氟醚浓度、呼末N2O浓度、MAC等观察指标，组间比较Plt;0.05 (P=0.011)，组内诱导后1h SpO2、乳酸盐与诱导前比较Plt;0.05 (P=0.000)，组内诱导后4h MAC、呼末异氟醚浓度、呼末N2O浓度与诱导后3h比较，Plt;0.05。两组诱导前、诱导后1h、2h、3h、4h的血气变化，组间比较Plt;0.05 (P=0.040)，组内诱导后2h pH与诱导后1h，比较Plt;0.05 (P=0.015)，组内诱导后3h pH与诱导后2h，比较Plt;0.05 (P=0.015)。 结论 与术中输入醋酸钠林格液相比，输入乳酸钠林格液的病人有一过性血乳酸盐值升高及血pH值偏低现象。 【关键词】 乳酸钠；醋酸钠；脊柱手术；全身麻醉 The study of the effect to the blood lactate and the acid-base balance when given the lactated Ringers and acetated sodium solution during the operation 【Abstract】 Objective TO compare the different changes of blood lactate and blood gases when given the lactated Ringers solution and acetated sodium solution during operation. Methods 40 patients are divided equally into the lactated Ringer’s group(group L) and the acetated sodium group(group A)randomly，adapting the combined intravenous and inhalation general anesthesia. The lactated Ringers gis given in group L and the acetated sodium in group A. Neither groups are cross-given other crystal solution during operation， polygeline is the only colloid solution in both groups. Observe the changes of blood lactate，SpO2 ，PETCO2，the end expiratory concentration of isoflurane and N2O，MAC and blood gases before the induction and at 1h，2h，3h and 4h after induction. Results There is no statistics difference(Pgt;0.05)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.The normal value of lactate is 0.50～2.22mmol/L. The observation index of blood lactate，SpO2 ，PETCO2，the end expiratory concentration of isoflurane an