Skak C, Ejlersen E, Mogensen T, Winkel P, Secher N H
Department of Anesthesia, Rigshospitalet, University of Copenhagen, Denmark.
Clin Transplant. 1996 Apr;10(2):157-9.
Patients with severe liver disease and accompanying malnutrition may exhibit electrolyte disturbances including the magnesium balance. In 18 patients plasma magnesium (p-Mg) was determined at the start of the liver transplantation and during the anhepatic and reperfusion phases of the operation. The blood loss was 6.9 (2.5-8.8) 1 (median and range) and the cumulative transfusion volume was 10.2 (5.0-17.2) 1 of which 5.9 (2.5-14.2) 1 was with fresh frozen plasma. p-Mg was 0.72 (0.58-0.88) mmol.l-1 and it did not change significantly during the operation. Thus, in 4 patients it was at or below the lower reference value of 0.67 mmol.l-1. In 11 patients it changed less than 0.05 mmol.l-1, while in 4 patients the concentration was rose, and in 3 patients we noted a fall in each of 0.08 mmol.l-1. There was no correlation between p-Mg and the blood loss or the administered volume of fresh frozen plasma. In 10 randomly chosen fresh frozen plasma units, the p-Mg was 0.64 (0.61-0.71) mmol.l-1. These observations do not support a need for close monitoring or substitution of magnesium during human liver transplantation. On the other hand, the finding of a low value in 4 of 18 patients suggests that plasma magnesium should be monitored and eventually corrected while the patient is on the waiting list.
患有严重肝病并伴有营养不良的患者可能会出现包括镁平衡在内的电解质紊乱。对18例患者在肝移植开始时以及手术的无肝期和再灌注期测定了血浆镁（p-Mg）。失血量为6.9（2.5 - 8.8）升（中位数和范围），累计输血量为10.2（5.0 - 17.2）升，其中5.9（2.5 - 14.2）升为新鲜冰冻血浆。p-Mg为0.72（0.58 - 0.88）mmol·L⁻¹，手术期间无显著变化。因此，4例患者的p-Mg处于或低于0.67 mmol·L⁻¹的参考下限值。11例患者的p-Mg变化小于0.05 mmol·L⁻¹，4例患者浓度升高，3例患者各下降0.08 mmol·L⁻¹。p-Mg与失血量或新鲜冰冻血浆输注量之间无相关性。在随机选取的10个新鲜冰冻血浆单位中，p-Mg为0.64（0.61 - 0.71）mmol·L⁻¹。这些观察结果不支持在人体肝移植期间密切监测或补充镁的必要性。另一方面，18例患者中有4例p-Mg值较低，这表明在患者等待肝移植期间应监测血浆镁并最终进行纠正。
