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碳酸氢钠林格氏液对肝移植术中血气分析及术后恢复时间的影响:单中心回顾性研究。

Effect of Sodium Bicarbonate Ringer's Solution on Intraoperative Blood Gas Analysis and Postoperative Recovery Time in Liver Transplantation: A Single-Center Retrospective Study.

机构信息

Department of Anesthesiology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland).

出版信息

Ann Transplant. 2023 Apr 28;28:e939097. doi: 10.12659/AOT.939097.

Abstract

BACKGROUND Sodium bicarbonate Ringer's solution (BRS) is the latest generation of balanced crystal solutions. BRS does not increase the liver burden, but its impact in liver transplantation is unclear. The aim of this study was to investigate the effect of BRS as a fluid therapy on intraoperative blood gas analysis and postoperative recovery time in orthotopic liver transplantation (LT) patients. MATERIAL AND METHODS The study included 101 patients who received classical in situ liver transplantation at the Second Affiliated Hospital of Guangxi Medical University from November 2019 to January 2022. The patients were divided into 2 groups according to the intraoperative fluid infusion: the BRS group and the sodium lactate Ringer's solution group (LRS group). Intraoperative blood gas analysis, including pH, base excess (BE), bicarbonate, and lactic acid levels of radial artery blood, were collected after induction (T0), 30 min before opening (T1), 30 min after no liver period (T2), 30 min after opening (T3), and at the end of the operation (T4). Postoperative ICU catheter time, ICU stay time, and total hospitalization days were also recorded and compared between the 2 groups. RESULTS Lactic acid levels were decreased significantly at T3 in the BRS group (P<0.05). ICU catheter time, ICU hospitalization days, and total hospitalization days were significantly shorter in the BRS group (P<0.05). CONCLUSIONS BRS can decrease the lactic acid level at 30 min after opening, reducing the postoperative recovery time. BRS is more effective than LRS in liver transplantation.

摘要

背景

碳酸氢钠林格氏液(BRS)是最新一代的平衡晶体溶液。BRS 不会增加肝脏负担,但它在肝移植中的影响尚不清楚。本研究旨在探讨 BRS 作为液体疗法对原位肝移植(LT)患者术中血气分析和术后恢复时间的影响。

材料和方法

该研究纳入了 2019 年 11 月至 2022 年 1 月在广西医科大学第二附属医院接受经典原位肝移植的 101 例患者。根据术中输液分为 BRS 组和乳酸钠林格氏液组(LRS 组)。采集桡动脉血的 pH、碱剩余(BE)、碳酸氢盐和乳酸水平的术中血气分析,分别在诱导后(T0)、无肝期前 30 分钟(T1)、无肝期后 30 分钟(T2)、开放后 30 分钟(T3)和手术结束时(T4)。记录并比较两组患者术后 ICU 导管时间、ICU 住院时间和总住院天数。

结果

BRS 组 T3 时乳酸水平显著降低(P<0.05)。BRS 组 ICU 导管时间、ICU 住院天数和总住院天数明显缩短(P<0.05)。

结论

BRS 可降低开放后 30 分钟时的乳酸水平,缩短术后恢复时间。BRS 在肝移植中比 LRS 更有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b004/10152902/ed9579bb7842/anntransplant-28-e939097-g001.jpg

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