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复方果糖电解质注射液在骨创伤患者中的疗效观察 |
李雨虹1△,杨素霞1△,孙璟川2,陈宇童1,李烟花1,濮世俊1,季美丽1,朱有华1,隋明星1* |
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(1. 海军军医大学(第二军医大学)第一附属医院器官移植科, 上海 200433; 2. 海军军医大学(第二军医大学)第二附属医院骨科, 上海 200003 △共同第一作者 *通信作者) |
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摘要: |
目的 探讨复方果糖电解质注射液在骨创伤患者中的临床疗效和应用价值。方法 纳入2020年1月至2021年6月在海军军医大学(第二军医大学)第二附属医院行骨创伤切开复位内固定术的患者80例,随机分为对照组和试验组,每组40例。对照组患者术后采用常规补液方案(5%葡萄糖氯化钠注射液与5%葡萄糖注射液各1 000 mL/d静脉滴注,其中5%葡萄糖注射液中添加1.5 g氯化钾和1 g葡萄糖酸钙),试验组患者术后给予复方果糖电解质注射液2 000 mL/d静脉滴注,疗程均为5 d。观察两组患者的血糖、肝肾功能、电解质水平、血液流变学和凝血功能、手术与术后相关指标及伤口愈合情况。结果 术后所有患者生命体征平稳。对照组术后第1、2、5天给药后即刻及给药后2 h血糖水平均高于试验组(P均<0.01),对照组的血糖水平波动较大。试验组患者术后1、5 d全血比高切黏度、全血比低切黏度、血浆比黏度均低于对照组(P均<0.05),凝血酶原时间均高于对照组(P均<0.05),但两组患者的肝肾功能、电解质水平、手术时间、术中出血量、术后引流量、拆线天数差异均无统计学意义(P均>0.05)。结论 复方果糖电解质注射液可安全、有效地应用于骨创伤患者的术后补液治疗,对患者的血糖、肝肾功能和电解质水平等影响均较小,同时可以降低血液黏滞度,降低血栓风险。 |
关键词: 复方果糖电解质注射液 骨创伤 血糖 电解质 血液流变学 |
DOI:10.16781/j.CN31-2187/R.20211016 |
投稿时间:2021-10-09修订日期:2022-04-18 |
基金项目:全军医学科技青年培训计划应用基础研究项目(21QNY041),海军军医大学(第二军医大学)第一附属医院“深蓝123”军事医学研究专项探索培育项目(2020SLZ007). |
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Compound fructose electrolyte injection in patients with bone trauma:efficacy observation |
LI Yu-hong1△,YANG Su-xia1△,SUN Jing-chuan2,CHEN Yu-tong1,LI Yan-hua1,PU Shi-jun1,JI Mei-li1,ZHU You-hua1,SUI Ming-xing1* |
(1. Department of Organ Transplantation, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China; 2. Department of Orthopaedics, The Second Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200003, China △Co-first authors. * Corresponding author) |
Abstract: |
Objective To explore the clinical efficacy and application value of compound fructose electrolyte injection in patients with bone trauma. Methods A total of 80 patients who underwent open reduction and internal fixation of bone trauma in The Second Affiliated Hospital of Naval Medical University (Second Military Medical University) from Jan. 2020 to Jun. 2021 were enrolled and randomly divided into control group (n=40) and experimental group (n=40). The patients in the control group were treated with routine fluid resuscitation scheme (intravenous drip of 5% glucose and sodium chloride injection 1 000 mL/d and 5% glucose injection 1 000 mL/d, 1.5 g potassium chloride and 1 g calcium gluconate were added into the 5% glucose injection) after operation, and the patients in the experimental group were treated with intravenous drip of compound fructose electrolyte injection 2 000 mL/d after operation, both for 5 d. Blood glucose, liver and kidney function, electrolyte level, hemorheology and coagulation function, operative and postoperative related indexes, and wound healing were observed in the 2 groups. Results The postoperative vital signs of all patients were stable. The levels of blood glucose immediately and 2 h after administration on the 1st, 2nd, and 5th day after operation in the control group were significantly higher and with larger fluctuation range than those in the experimental group (all P<0.01). The whole blood specific high shear viscosity, whole blood specific low shear viscosity, plasma specific viscosity in the experimental group were significantly lower than those in the control group 1 and 5 d after operation (all P<0.05), and prothrombin time was significantly higher than that in the control group (both P<0.05). There were no significant differences in liver or kidney function, electrolyte level, operation time, intraoperative blood loss, postoperative drainage, or suture removal days between the 2 groups (all P>0.05). Conclusion Compound fructose electrolyte injection is safe and effective for postoperative rehydration in bone trauma patients, with less interference on blood glucose, liver and kidney function, and electrolyte level. Meanwhile, it can reduce blood viscosity and decrease the risk of thrombosis. |
Key words: compound fructose electrolyte injection bone trauma blood glucose electrolyte hemorheology |