Intraoperative Infusion of Acetated Ringer Solution Containing Glucose and Ionized Magnesium Reduces Ketogenesis and Maintains Serum Magnesium

手術期間灌輸含葡萄糖及游離鎂的醋酸格林溶液降低生酮作用及維持血清鎂

Takeshi Yokoyama ； Kunio Suwa ； Fumiyasu Yamasaki ； Reiko Yokoyama ； Koichi Yamashita ； Eva Selldén

《Asia Pacific Journal of Clinical Nutrition》 17卷3期 (2008/09) Pp. 525-529

https://doi.org/10.6133/apjcn.2008.17.3.21

摘要

手術期間葡萄糖灌輸對葡萄糖代謝的影響並未透徹研究。本研究檢測手術期間灌輸含1%葡萄糖及游離鎂的醋酸格林溶液對生酮作用及血清鎂濃度的影響。歸類為ASA I-II 的病人（年齡51-80歲）隨機分組接受醋酸格林溶液灌輸。G/Mg 組接受含1%葡萄糖、140 meq/L 鈉離子及2 meq/L 鎂離子，C 組接受130 meq/L 鈉離子但不含葡萄糖及鎂的溶液。兩種溶液在第一小時都是以25mL/Kg 速度灌注，隨後維持每小時4 mL/Kg。收集3 次血液樣本：灌注前、灌注開始1 小時及4 小時各一次。分析每個樣本的電解質及葡萄糖代謝。快速灌注後，G/Mg 組病人的血糖值顯著上升至170±19 mg/dL，但4 小時後即回到基礎值，而血清酮體並未增加。反之，C 組病人的血糖值從未超過110mg/dL，但在第3 測量點的酮酸-乙醯乙酸及氫氧化丁酸濃度都顯著升高。

關鍵字

手術間灌輸 ； 葡萄糖代謝 ； 酮酸中毒 ； 胰島素 ； 鎂

並列摘要

The effect of glucose infusion during surgery on glucose metabolism has not been investigated sufficiently. We, therefore, examined the effect after the infusion of 1% glucose acetated Ringer solution containing Mg2+ during surgery on ketogenesis and serum Mg2+ concentrations. Patients, classified as ASA I-II, age 51-80 years, were randomly assigned to receive infusion of acetated Ringer solution. The G/Mg group received infusion with 1% glucose, Na+ 140mEq/L, Mg2+ 2 mEq/L, and the C group received infusion with glucose free solution containing Na+ 130 mEq/L without Mg2+. Both solutions were infused at a rate of 25 mL/kg for the first hour, and maintained at 4 mL/kg/hr thereafter. Blood samples were collected three times: before infusion and at 1 hour and 4 hours after the start of infusion. Electrolytes and glucose metabolism were evaluated at each sampling. After rapid infusion, blood glucose level significantly increased to 170±19mg/dL in the G/Mg group, but it returned to close to baseline after 4 hours and serum ketone bodies did not increase during infusion. In the C group, however, blood glucose never increased beyond 110 mg/dL, but both acetoacetic and hydroxybutyric acids increased significantly at the third measurement.

並列關鍵字

perioperative infusion ； glucose metabolism ； ketogenesis ； insulin ； magnesium