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大容量抽脂术后电解质和血常规变化:比较两种不同的肿胀液

Electrolyte and Haemogram changes post large volume liposuction comparing two different tumescent solutions.

作者信息

Vivek Kumar, Amiti Shah, Shivshankar Saha, Lalit Choudhary

机构信息

Department of Plastic Surgery, Sir Ganga Ram Hospital, New Delhi, India.

出版信息

Indian J Plast Surg. 2014 Sep-Dec;47(3):386-93. doi: 10.4103/0970-0358.146604.

Abstract

BACKGROUND

The most common definitions of large volume liposuction refer to total 5 l volume aspiration during a single procedure (fat plus wetting solution). Profound haemodynamic and metabolic alterations can accompany large volume liposuction. Due to paucity of literature on the effect of different tumescent solutions on the electrolyte balance and haematological changes during large volume liposuction, we carried out this study using two different wetting solutions to study the same.

MATERIALS AND METHODS

Total 30 patients presenting with varying degrees of localized lipodystrophy in different body regions were enrolled for the study. Prospective randomized controlled trial was conducted by Department of Plastic and Cosmetic Surgery, Sir Ganga Ram Hospital, New Delhi from January 2011 to June 2012. Patients were randomized into two groups of 15 patients each by using computer generated random numbers. Tumescent formula used for Group A (normal saline [NS]) was our modification of Klein's Formula and Tumescent formula used for Group B (ringer lactate [RL]) was our modification of Hunstadt's formula. Serum electrolytes and hematocrit levels were done at preinduction, immediate postoperative period and postoperative day 1.

RESULT

Statistical analysis was performed using SPSS software version 15.0. Which showed statistically significant electrolytes and hematocrit changes occur during large volume liposuction.

CONCLUSION

Statistically significant electrolytes and hematocrit changes occur during large volume liposuction and patients should be kept under observation of anaesthesist for at least 24 h. Patients require strict monitoring of vital parameters and usually Intensive Care Unit is not required. There was no statistical difference in the electrolyte changes using NS or RL as tumescent solution and both solutions were found safe for large volume liposuction.

摘要

背景

大量吸脂最常见的定义是单次手术中吸出的总量达5升(脂肪加冲洗液)。大量吸脂可能伴随深刻的血流动力学和代谢改变。由于关于不同肿胀液对大量吸脂过程中电解质平衡和血液学变化影响的文献较少,我们使用两种不同的冲洗液进行了本研究以探讨这一问题。

材料与方法

本研究纳入了30例不同身体部位存在不同程度局部脂肪营养不良的患者。2011年1月至2012年6月,新德里甘加拉姆爵士医院整形与美容外科开展了一项前瞻性随机对照试验。通过计算机生成随机数将患者随机分为两组,每组15例。A组(生理盐水[NS])使用的肿胀配方是我们对克莱因配方的改良,B组(乳酸林格液[RL])使用的肿胀配方是我们对洪斯塔德配方的改良。在诱导前、术后即刻和术后第1天检测血清电解质和血细胞比容水平。

结果

使用SPSS 15.0软件进行统计分析。结果显示,大量吸脂过程中电解质和血细胞比容发生了具有统计学意义的变化。

结论

大量吸脂过程中电解质和血细胞比容发生了具有统计学意义的变化,患者应在麻醉医生的观察下至少24小时。患者需要严格监测生命体征参数,通常不需要入住重症监护病房。使用NS或RL作为肿胀液时,电解质变化无统计学差异,两种溶液用于大量吸脂均安全。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64c0/4292117/a15e1049d785/IJPS-47-386-g003.jpg

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