术后细胞外液缺失及其用乳酸林格液的纠正。一项重新评估。
Extracellular fluid deficit following operation and its correction with Ringer's lactate. A reassessment.
作者信息
Roberts J P, Roberts J D, Skinner C, Shires G T, Illner H, Canizaro P C, Shires G T
出版信息
Ann Surg. 1985 Jul;202(1):1-8. doi: 10.1097/00000658-198507000-00001.
The changes in extracellular fluid volume (ECV) in two groups of surgical patients, one receiving Ringer's lactate solution intraoperatively and the other receiving only dextrose and water, were assessed. A deficit in the ECV, as measured by radioactive sulfate, of 1.9 +/- 0.8 l (p less than 0.003) compared to the preoperative volume was found in the dextrose group. This was accompanied by a decrease in the mean creatinine clearance (-13% p less than 0.01), the mean urinary sodium excretion (-57% p less than 0.05), and the mean rate of clearance of the sulfate tracer (-18% p less than 0.01). The use of intraoperative Ringer's lactate (1660 cc +/- 96 cc) resulted in no change in the ECV, an increase in the mean creatinine clearance (+10% p less than 0.05), and no change in sodium excretion or tracer clearance. As a result of these findings, it appears that postoperative sodium retention is a physiologic response to a decreased ECV, which can be prevented by the administration of Ringer's lactate.
对两组外科手术患者的细胞外液量（ECV）变化进行了评估，一组术中输注乳酸林格氏液，另一组仅输注葡萄糖和水。通过放射性硫酸盐测量发现，葡萄糖组的ECV较术前减少了1.9±0.8升（p<0.003）。这伴随着平均肌酐清除率下降（-13%，p<0.01）、平均尿钠排泄减少（-57%，p<0.05）以及硫酸盐示踪剂平均清除率下降（-18%，p<0.01）。术中使用乳酸林格氏液（1660毫升±96毫升）导致ECV无变化，平均肌酐清除率增加（+10%，p<0.05），钠排泄和示踪剂清除率无变化。基于这些发现，术后钠潴留似乎是对ECV降低的一种生理反应，可通过输注乳酸林格氏液来预防。
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