碳酸氢钠林格氏液对开放右半肝切除术镁离子和的炎性因子影响

Effect of Bicarbonate Ringer’s Solution on Magnesium Ion and Inflammatory Factors in Patients Undergoing Open Right Hepatectomy

摘要: 目的：该文旨在观察碳酸氢钠林格氏液(BRS)对开放右半肝切除术患者术后血清镁和炎性因子的影响。方法：选取安徽医科大学第二附属医院2020年10月至2021年4月收治择期全麻下开放右半肝切除术患者60例，男35例，女25例，年龄40~65岁，BMI 18~26 kg∕m²，ASA分级II或III级，采用随机数字表法分为两组：乳酸钠林格氏液组(L组)和碳酸氢钠林格氏液组(B组)，两组采用5~7 ml/kg⁻¹∙h⁻¹为基础输液速度分别使用乳酸钠林格氏液和碳酸氢钠林格氏液。记录术前(T0)、手术结束时(T₁) PH、BE、HCO₃^- 、LAC值，记录T₀、术后1 d (T₂)、术后3 d (T₃)镁离子浓度，记录T₀、T₂、T₃时血浆白细胞介素-6 (IL-6)、肿瘤坏死因子-α (TNF-α)水平。记录患者术后住院时间、术后1个月、6个月、12个月的死亡率。结果：与T₀相比，T₁时L组PH、BE、HCO₃^-降低，Lac值升高，T₂时L组镁离子浓度水平降低，T₂、T₃时两组IL-6、TNF-α水平升高(P < 0.05)，与L组相比，B组T₁时PH、BE、HCO₃^-升高，Lac值降低，T₂时镁离子浓度升高，T₂、T₃时IL-6、TNF-α水平降低，术后住院时间缩短，术后12个月死亡率下降(P < 0.05)。结论：碳酸氢钠林格氏液维持开放右半肝切除术术后酸碱平衡和镁离子浓度，减轻术后炎性反应，降低术后死亡率。

Abstract: Objective: To observe the effect of Bicarbonate Ringer’s solution (BRS) on magnesium ion and inflammatory factors in patients undergoing open right hepatectomy. Methods: Sixty patients, including 35 males and 25 females, aged 40 to 65 years, with BMI 18 to 26 kg/m², ASA grade II or III, who were admitted to the Second Affiliated Hospital of Anhui Medical University from October 2020 to April 2021 for elective open right hepatectomy under general anesthesia were selected and divided into two groups by random number table method. Sodium lactate Ringer’s solution (group L) and Bicarbonate Ringer’s solution (group B) were used at the infusion rate of 5~7 ml/kg⁻¹∙h⁻¹ crystal solution, respectively. Record the values of PH, BE, HCO₃^-, LAC before operation (T₀) and at the end of operation (T₁). Record T₀, postoperative 1 d (T₂), postoperative 3 d (T₃) magnesium ion concentration, and record plasma interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels at T₀, T₂, and T₃. Record the postoperative hospital stay, mortality rate at 1 month, 6 months, and 12 months after surgery. Results: Compared with T₀, the PH, BE, HCO₃^- of the L group decreased, the Lac value increased at T₁, the magnesium ion concentration level of L group decreased at T₂, and the IL-6 and TNF-α levels of the two groups increased at T₂ and T₃ (P < 0.05). Compared with group L, PH, BE, HCO₃^-increased at T₁, Lac value decreased, magnesium ion concentration increased at T₂, IL-6 and TNF-α levels decreased at T₂, T₃, and postoperative hospital stay was shortened; the mortality rate decreased in 12 months after operation of group B (P < 0.05). Conclusion: Bicarbonate Ringer’s solution maintains the concentration of magnesium ions after open right hepatectomy, reduces postoperative inflammatory reactions, and reduces postoperative mortality rate.