Zhang X Y
First Affiliated Hospital, China Medical University, Shenyang.
Zhonghua Wai Ke Za Zhi. 1990 Apr;28(4):225-7, 253.
Blood phosphorus was measured in consecutive 136 admitted patients in the department of general surgery between Oct. 1987 and Jan. 1988. It was found that 32 cases (23.5%) were with hypophosphatemia on perioperative period. Sixteen patients with normal preoperative blood phosphorus level undergoing digestive tract surgery were randomly divided into 3 groups, each was fasted for 7 days postoperation and given different kind of transfusions. Group 1, patients were given 250 g of glucose daily with no phosphorus, blood phosphorus level was significantly decreased. Group 2, 250 g of glucose with 7.5 mmol of phosphate daily, blood phosphorus level decreased slightly on the 2nd-4th day and returned back to normal on day 7. Group 3,500 g of glucose with 15 mmol of phosphate daily, blood phosphorus level decreased moderately on the 2nd-4th day, and returned to normal level on day 7. Perioperative hypophosphatemia was attributed to: (1) Poor absorption or massive loss of phosphorus through digestive tract. (2) Intracellular transferring of blood phosphorus accompanied by the phosphorylation of saccharide. (3) Excessive excretion of phosphorus through urine. The authors suggested that 7-9 mmol of phosphates per 100 kcal daily for the prevention and 7-15 mmol of phosphates per 1000 kcal daily for the treatment of hypophosphatemia.
1987年10月至1988年1月期间，对普外科连续收治的136例患者进行了血磷测定。结果发现，32例（23.5%）患者围手术期存在低磷血症。将16例术前血磷水平正常且接受消化道手术的患者随机分为3组，每组患者术后禁食7天，并给予不同类型的输血。第1组患者每天给予250克无磷葡萄糖，血磷水平显著下降。第2组患者每天给予250克葡萄糖加7.5毫摩尔磷酸盐，血磷水平在第2至4天略有下降，第7天恢复正常。第3组患者每天给予500克葡萄糖加15毫摩尔磷酸盐，血磷水平在第2至4天中度下降，第7天恢复正常水平。围手术期低磷血症的原因如下：（1）磷通过消化道吸收不良或大量丢失。（2）血磷向细胞内转移并伴有糖类磷酸化。（3）磷通过尿液过度排泄。作者建议，预防低磷血症时每天每100千卡给予7 - 9毫摩尔磷酸盐，治疗低磷血症时每天每1000千卡给予7 - 15毫摩尔磷酸盐。
