The Effects Of Sodium Potassium Magnesium Calcium Glucose Injection In Patients Undergoing Resection Of Hepatic Lobe Surgery

China is a country of liver disease and the trend is increasing year byyear,and the resection of hepatic lobe is the most effective means of liverspace-occupying lesions treatment, But the surgery is more bleeding, theoperation time is long and the irritable stimulation of live resection, and theapplication of intraoperative anesthetic to liver function will cause a certaindegree of damage, therefore in the process of the operation effectivelyprotecting the liver function is very important on the one hand duringprotection of important organs perioperativethe. The fluid therapy is anintegral part during the operation, compared to Lactated Ringer’s solution,sodium potassium magnesium calcium glucose injection is a new type ofexcluding lactic acid crystal fluid, the buffer system use acetic acid instead oflactic acid, containing magnesium ion and1%glucose etc. This experimentmainly study the application of safety and effectiveness of potassium sodiumcalcium magnesium glucose injection in heaptic resection patients during theoperation.Objective： Checking sodium potassium magnesium calcium glucoseinjection the safety and effectiveness in patients with liver resectionMethods：20patients undergoing hepatic resection,10males and10females, aged,18-65years old, ASA Ⅰ~Ⅱ, primary and secondary malignant liver tumors (16cases), hepatic hemangioma4cases, There wererandomly divided into domestic A group and the import of R group,15caseseach, the patients with diabetes, high blood pressure or heart, lung, braindisease in the preoperative examination is not in the list.After enter the operation room, opening venous access,monitoring bloodpressure, heart rate, pulse oxygen saturation,in the left radial artery punctureunder local anesthesia,monitoring of invasive blood pressure. inhalationanesthesia,before induction inject penehyclidine hydrochloride1mg and allpatients were treated with general anesthesia,compound intravenous Inductionof anesthesia: followed by intravenous infusion midazolam0.04mg/kg,propofol1.5mg/kg cis-atracurium0.2mg/kg, sufentanil0.4μg/kg,supply oxygen with mask in order to remove N2,3-5min to endotrachealintubation, then put through anesthesia machine and mechanical ventilation,tidal volume8-10ml/kg, respiratory rate12bpm. Anesthesia maintenance:intraoperative inhaled sevoflurane1.2-1.5MAC, intermittent to givecis-atracurium、sufentanil and propofol, to maintain the appropriate depth ofanesthesia. After the anesthesia induction punctures the internal jugular vein orsubclavian vein and catheters. The patients of two groups began to infusionafter the opening of the peripheral vein, A group input the sodium potassiummagnesium calcium glucose injection, R group infuse the sodium lactate lingfluid, to supple the loss quantity of the preoperative, physiological requirementand the vasodilation required capacity causeing by anesthetic drugs, then according to the intraoperative CVP to adjust infusion speed, to maintain theintraoperative infusion with eight (ml/kg/h) speed, input crystal fluid andcolloid ratio of2:1, monitoring the mean arterial pressure (MPA) and heart rate(HR) extraction radial artery blood gas analysis-electrolyte (Na+, K+, Ca2+,Mg2+), alkali residual (BE), blood sugar, HTC (%), PH value, lactic acidconcentration on the index.before anesthesia (T0), at the beginning of operation(T1), tumor resection (T2), at the end of surgery and postoperative (T3) and h(T4)5point at the end of the infusion immediately the time point.Results：It is processed by statistical methods SPSS17.0softwarestatistics, measurement data express with mean±standard deviation (plus orminus s), the group comparein use the single factor analysis of variance,compares the interclass use variance analysis, each group compares with the ttest, P <0.05has the statistical significance, the input of A group is (1447±210) ml, the input of R group is(1400±190) ml, the infusion quantity oftwo groups has no significant difference (P>0.05), the intraoperative bloodloss, group A is (635±153) ml, R group is (655±137) ml, two groups has nosignificant difference (P>0.05). The HR, MAP and Hct of two groupsdecline, but has no significant difference (p>0.05), in the normal range, thecomparison between the two groups have no statistical difference (p>0.05).The comparison of sodium, potassium, and calcium ions in the group andbetween the group have no statistically significant differences. two groups isdeclineing,the magnesium ion of R group decreases evidently (P﹤0.05), in T3, T4, compared with T0at time, The comparison between the two groups inT3, T4date,the magnesium ion of R group than A group of magnesium iondeclines more obvious (P﹤0.05). The blood glucose concentration of twogroups of increases, but the R group in normal range, the blood sugar of Agroup, in T2, T3and T4date compareing with time T0, has significantly higher(P﹤0.05), The comparison between the two groups in T3, T4date, the bloodsugar of A group o increases significantly more obvious (P﹤0.05). Thelactic acid concentration of the two groups increases, but A group is innormal range, lactic acid concentration of R group, in T3, T4timecompareing with T0,express significantly higher (P﹤0.05),The comparisonbetween the two groups in T3, T4date,the lactic acid concentration of R groupincrease more obvious than A group(P﹤0.05).Conclusions：Sodium potassium magnesium calcium glucose injection,and the sodium lactate ringer’injection have the same safety and effectiveness,and can effectively reduce the lactic acid concentration, have a more advantagefor patients in hepatic lobe resection surgery.