琥珀酰明胶电解质醋酸钠注射液的临床应用 进展

Clinical Application Progress of Sodium Acetate Succinyl Gelatin Electrolyte Injection

摘要: 围手术期液体治疗是麻醉与外科临床核心，需维持血管内容量稳定、组织器官有效灌注及内环境平衡，以降低术后并发症、促进康复。人工胶体液是围手术期容量替代的重要选择，琥珀酰明胶类制剂因生物相容性好、过敏风险低、扩容效果明确，临床应用广泛。传统琥珀酰明胶注射液以生理盐水为载体，大量输注易引发高氯性酸中毒、电解质紊乱，不符合精准治疗理念。琥珀酰明胶电解质醋酸钠注射液作为改良型平衡胶体液，以醋酸平衡液替代生理盐水，优化电解质配比，更贴近人体生理状态。本文结合权威指南及相关研究，对比琥珀明胶注射液与琥珀酰明胶电解质醋酸钠注射液，证实后者在维持酸碱平衡、控制氯离子水平、减少电解质紊乱方面更优，且安全性可。但需注意，该制剂存在潜在局限性，如严重肝功能衰竭患者中醋酸根代谢可能受阻且相对较高的成本带来一定药物经济学挑战。本文同时提出琥珀酰明胶电解质醋酸钠注射液更契合指南核心要求，是高氯血症高风险人群、长时间全麻非心脏手术的优选方案，但对术前存在代谢性碱中毒等特殊临床场景的适配性仍需个体化评估，进而为临床制剂选择及指南更新提供了循证参考。

Abstract: Perioperative fluid therapy is core to anesthetic and surgical practice, requiring the maintenance of intravascular volume stability, effective tissue and organ perfusion, and internal environment balance to reduce postoperative complications and promote recovery. Artificial colloids are an important choice for perioperative volume replacement, and succinylated gelatin preparations are widely used clinically due to their good biocompatibility, low allergic risk, and definite volume expansion effect. Traditional succinylated gelatin injection uses normal saline as the carrier, and large-volume infusion is prone to causing hyperchloremic acidosis and electrolyte disorders, which is inconsistent with the concept of precise therapy. As an improved balanced colloid, sodium acetate succinyl gelatin electrolyte injection replaces normal saline with acetate balanced solution, optimizes the electrolyte ratio, and is closer to the human physiological state. Based on authoritative guidelines and relevant studies, this paper compares succinylated gelatin injection with sodium acetate succinyl gelatin electrolyte injection, confirming that the latter is superior in maintaining acid-base balance, controlling chloride ion levels, and reducing electrolyte disorders, with reliable safety. However, it is necessary to note that this preparation has potential limitations, such as possible impairment of acetate metabolism in patients with severe liver failure, and certain pharmacoeconomic challenges brought by its relatively high cost. This paper also proposes that sodium acetate succinyl gelatin electrolyte injection is more in line with the core requirements of guidelines, serving as the preferred option for perioperative fluid therapy in high-risk populations of hyperchloremia and long-duration non-cardiac surgery under general anesthesia. Nevertheless, its adaptability to specific clinical scenarios such as pre-existing metabolic alkalosis requires individualized evaluation, thereby providing evidence-based reference for clinical preparation selection and guideline updates.