[转载]临床治疗中晶体液的选择
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临床治疗中晶体液的选择
乳酸林格，勃力脉，normosol-R
乳酸由肝脏分解产生碳酸氢钠，考虑选择其他晶体液；
不要在乳酸林格中加入血液制品，防止钙离子沉淀抗凝血
0.9%氯化钠，林格氏液
降低PH,`氯和氢离子丢失
可能需要补充钾离子
等张或1/2张乳酸林格
最少的钠，增加血管内容量，可能增加液体超载
不要在乳酸林格液加入血液制品，防止钙离子沉淀抗凝血
0.9%氯化钠
不含钙；相对高钠水平可以促进利尿作用
可能需要补充钾离子
比其他等渗晶体替代液相对低钠
不要在乳酸林格中加入血液制品，防止钙离子沉淀抗凝血
肾上腺皮质机能减退
0.9%氯化钠
不含钾，高钠增加钠替代
勃力脉，normosol-R
避免乳酸缓冲，对于门静脉高压低钠
肾衰-高钠末期
勃力脉，normosol-R，1/2张乳酸林格
避免高钠降低肾小球滤过率
不要在乳酸林格中加入血液制品，防止钙离子沉淀抗凝血
肾衰-少尿或无尿
0.9%氯化钠
避免保留钾
密切监测钠水平
休克复苏-低血容量
乳酸林格，勃力脉，normosol-R
缓冲溶液，替代血管容量
乳酸由肝脏分解产生碳酸氢钠，考虑选择其他晶体液；
不要在乳酸林格中加入血液制品，防止钙离子沉淀抗凝血
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