Rasmussen A, Kimose H H, Hessov I
University Department of Surgery K, Aarhus County Hospital, Denmark.
Acta Chir Scand. 1988 Nov-Dec;154(11-12):617-21.
Major surgery is associated with fall in the concentration of inorganic phosphate in serum, as is intravenous infusion of glucose. Hypophosphatemia during different forms of postoperative dextrose administration was evaluated in patients who had undergone colorectal surgery. They were randomized to two groups. All patients received standardized intravenous fluids on the first 3 postoperative days, but one group had constant infusion of a solution containing glucose (4%), sodium (40 mmol/l) and potassium (20 mmol/l) throughout the observation period, while the other group had a 5-hour infusion of 10% glucose daily, with potassium and sodium solution in between. The amounts of administered glucose and electrolytes were the same in both groups. The serum phosphate levels were significantly lower in the group with constant glucose infusion, due to intergroup difference in renal handling of phosphate. Significantly less phosphate was reabsorbed in the proximal tubules when glucose was given as 24-hour infusion than in the group with 5-hour infusion.
大手术与血清中无机磷酸盐浓度下降有关，静脉输注葡萄糖也是如此。对接受结直肠手术的患者在不同形式的术后葡萄糖给药期间的低磷血症进行了评估。他们被随机分为两组。所有患者在术后的前3天接受标准化静脉输液，但一组在整个观察期内持续输注含有葡萄糖（4%）、钠（40 mmol/L）和钾（20 mmol/L）的溶液，而另一组每天输注5小时的10%葡萄糖，其间输注钾和钠溶液。两组给予的葡萄糖和电解质的量相同。由于两组在肾脏对磷酸盐的处理上存在差异，持续输注葡萄糖组的血清磷酸盐水平显著较低。当葡萄糖以24小时输注时，近端小管中重吸收的磷酸盐明显少于5小时输注组。
