不同剂量静脉输注葡萄糖对术后代谢变化的影响。
The effect of varying amounts of intravenous glucose on the metabolic changes after surgery.
作者信息
Swaminathan R, Bradley J A, Hill G H, Morgan D B
出版信息
Postgrad Med J. 1980 Sep;56(659):652-5. doi: 10.1136/pgmj.56.659.652.
The metabolic effects of saline, 30 of glucose a day and 129 g of glucose a day were studied in patients after either cholecystectomy or highly selective vagotomy. In the saline group the blood ketone concentration increased to 3.3 mmol/l on the 5th day after surgery, but this increase was completely abolished by a daily intake of 129 g of glucose and almost completely so by 30 g of glucose. Urine nitrogen excretion expressed as nitrogen to creatinine ratio in the saline group increased from 42.5 to 66.2 by the third day after surgery, and there was a similar increase in the group given 30 g a day of glucose. However, 129 g/day of glucose completely prevented the increase in urine nitrogen, an effect which is similar to that reported in starving subjects given similar amounts of glucose. It is suggested that 129 g of glucose only prevents that part of the increase in nitrogen excretion which is due to starvation and that it has no effect on the increase in nitrogen excretion which happens as part of the metabolic response to surgery.
在胆囊切除术或高选择性迷走神经切断术后的患者中，研究了生理盐水、每天30克葡萄糖和每天129克葡萄糖的代谢效应。在生理盐水组中，术后第5天血酮浓度升至3.3毫摩尔/升，但每日摄入129克葡萄糖可使这种升高完全消除，每日摄入30克葡萄糖几乎可使其完全消除。生理盐水组以氮与肌酐比值表示的尿氮排泄在术后第3天从42.5增至66.2，每日给予30克葡萄糖的组也有类似升高。然而，每天129克葡萄糖完全阻止了尿氮的增加，这一效应与给饥饿受试者给予相似量葡萄糖时所报道的效应相似。提示129克葡萄糖仅能阻止因饥饿导致的那部分氮排泄增加，而对作为手术代谢反应一部分的氮排泄增加没有影响。
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