Isosu T, Akama Y, Tase C, Fujii M, Okuaki A
Department of Anesthesiology, Fukushima Medical College.
Masui. 1992 Nov;41(11):1707-13.
Acetated Ringer solution (AR) was studied clinically to find its usefulness in patients with liver dysfunction compared with lactated Ringer solution (LR). The thirty-eight patients scheduled to be operated were divided into four groups (Group I: with normal liver function and AR infused, Group II: with normal liver function and LR infused, Group III: with liver dysfunction and AR infused, Group IV: with liver dysfunction and LR infused). AR or LR was administered to each group at a speed of 10 ml.kg-1.h-1, and we investigated the differences of these four groups clinically. L-lactic acid increased significantly in all groups after administration of AR or LR. D-lactic acid increased in LR groups, and acetic acid increased in AR groups. However, the other parameters, including the acid-base balance, electrolytes and liver function, showed no significant changes in any group. Therefore the status of liver dysfunction did not affect the metabolism of lactic acid in this study. These findings indicate that as an intraoperative fluid, AR is just as useful as LR. However, there was no significant difference between the data of AR groups compared with those of LR groups. In conclusion, AR is not necessarily a better fluid compared with LR as an intraoperative fluid in patients with liver dysfunction.
对醋酸林格液(AR)进行了临床研究,以探讨其在肝功能不全患者中与乳酸林格液(LR)相比的效用。将计划接受手术的38例患者分为四组(第一组:肝功能正常且输注AR;第二组:肝功能正常且输注LR;第三组:肝功能不全且输注AR;第四组:肝功能不全且输注LR)。以10 ml·kg⁻¹·h⁻¹的速度向每组输注AR或LR,并对这四组进行临床差异研究。输注AR或LR后,所有组的L-乳酸均显著增加。LR组中D-乳酸增加,AR组中乙酸增加。然而,包括酸碱平衡、电解质和肝功能在内的其他参数在任何组中均无显著变化。因此,在本研究中肝功能不全的状态并未影响乳酸代谢。这些发现表明,作为术中液体,AR与LR一样有用。然而,AR组与LR组的数据之间没有显著差异。总之,在肝功能不全患者中,作为术中液体,AR不一定比LR更好。