McFarlane C, Lee A
Department of Anaesthetics and Intensive Care, Royal Infirmary, Edinburgh.
Anaesthesia. 1994 Sep;49(9):779-81. doi: 10.1111/j.1365-2044.1994.tb04450.x.
Thirty patients undergoing major hepatobiliary or pancreatic surgery were randomly allocated to receive either 0.9% saline or Plasmalyte 148 (a balanced salt solution), at 15 ml.kg-1.h-1. Arterial blood gas analysis was performed before and after surgery. Plasma biochemistry (Na+, K+, Cl-, lactate) measurements were made before and after surgery and at 24 h after surgery. The patients receiving 0.9% saline had significantly increased chloride concentrations (p < 0.01), decreased standard bicarbonate concentrations (p < 0.01) and increased base deficit (p < 0.01) compared to those receiving Plasmalyte 148. There were no significant changes in plasma sodium or potassium or blood lactate concentrations in either group. The exclusive use of 0.9% saline intra-operatively can produce a temporary hyperchloraemic acidosis which could be given false pathological significance. In addition it may exacerbate an acidosis resulting from an actual pathological state. The use of a balanced salt solution such as Plasmalyte 148 may avoid these complications.
30例行大型肝胆或胰腺手术的患者被随机分配，分别接受0.9%生理盐水或Plasmalyte 148（一种平衡盐溶液），输注速度为15毫升/千克/小时。手术前后均进行动脉血气分析。术前、术后及术后24小时测定血浆生化指标（钠、钾、氯、乳酸）。与接受Plasmalyte 148的患者相比，接受0.9%生理盐水的患者氯化物浓度显著升高（p<0.01），标准碳酸氢盐浓度降低（p<0.01），碱缺失增加（p<0.01）。两组患者的血浆钠、钾或血乳酸浓度均无显著变化。术中单纯使用0.9%生理盐水可导致暂时性高氯性酸中毒，这可能会被赋予错误的病理意义。此外，它可能会加重实际病理状态导致的酸中毒。使用平衡盐溶液如Plasmalyte 148可能避免这些并发症。
