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在年轻健康志愿者中,快速静脉输注或口服 2 升 0.9%生理盐水后,身体成分、血液参数和血清生化的变化:随机交叉研究。

Changes in body composition, hematologic parameters, and serum biochemistry after rapid intravenous infusion or oral intake of 2 liters of 0.9% saline solution in young healthy volunteers: randomized crossover study.

机构信息

Department of Surgery, Medical School, Federal University of Mato Grosso, Cuiaba, Brazil.

出版信息

World J Surg. 2012 Dec;36(12):2776-81. doi: 10.1007/s00268-012-1756-0.

Abstract

BACKGROUND

The perioperative infusion of 2 L of saline is associated with weight gain and decreased serum albumin and hematocrit. We hypothesized that these parameters would respond differently to oral administration and intravenous infusion of saline solution.

METHODS

This was a crossover study that included 10 healthy young men (ages 18-26 years). At two times, 8 weeks apart, the participants were randomized to receive 2 L of 0.9% saline over 1 h by intravenous (IV) administration to a forearm vein or by oral intake. The participants were weighed and body masses were calculated. Bioelectrical impedance analysis was performed with a single-frequency device using tetrapolar distal limb electrodes. Blood samples were collected 1 h after the administration period for laboratory assays: hematocrit, hemoglobin, blood glucose, serum electrolytes, albumin, creatinine, osmolality.

RESULTS

There was an increase in body weight (p<0.01), total body water (p<0.01), and lean body mass (p<0.01) after the experiment in both groups, with no difference between them. The volume of urine output was similar in the two experiments. The hemoglobin (oral group from 14.4±0.8 g/dl to 13.8±0.8 g/dl; IV group from 14.4±0.6 g/dl to 12.6±0.6 g/dl) and hematocrit (oral group from 43.2±1.8% to 43.2±2.8%; IV group from 43.6±2.2% to 40.0±2.6%) significantly decreased (p<0.01) with IV saline. Serum albumin remained stable after oral intake but significantly decreased (p=0.04) after IV infusion.

CONCLUSIONS

Oral intake of 2 L of 0.9% saline results in minimal variations in serum albumin, hemoglobin, and hematocrit when compared to IV infusion of the same volume.

摘要

背景

围手术期输注 2 升生理盐水会导致体重增加、血清白蛋白和血细胞比容降低。我们假设这些参数对口服和静脉输注生理盐水的反应会有所不同。

方法

这是一项交叉研究,纳入了 10 名健康年轻男性(年龄 18-26 岁)。在相隔 8 周的 2 个时间点,参与者随机接受 2 升 0.9%生理盐水静脉(IV)输注至前臂静脉或口服。参与者称重并计算体重。使用单频设备通过四肢远端电极进行生物电阻抗分析。给药后 1 小时采集血样进行实验室检测:血细胞比容、血红蛋白、血糖、血清电解质、白蛋白、肌酐、渗透压。

结果

两组实验后体重(p<0.01)、总体水量(p<0.01)和瘦体重(p<0.01)均增加,两组间无差异。两次实验的尿量相似。血红蛋白(口服组从 14.4±0.8 g/dl 降至 13.8±0.8 g/dl;IV 组从 14.4±0.6 g/dl 降至 12.6±0.6 g/dl)和血细胞比容(口服组从 43.2±1.8%降至 43.2±2.8%;IV 组从 43.6±2.2%降至 40.0±2.6%)显著降低(p<0.01),IV 生理盐水输注后降低更明显。口服摄入 2 升 0.9%生理盐水后血清白蛋白保持稳定,但 IV 输注后显著降低(p=0.04)。

结论

与 IV 输注相同体积相比,口服摄入 2 升 0.9%生理盐水对血清白蛋白、血红蛋白和血细胞比容的变化最小。

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