钙离子对全静脉营养液稳定性的影响
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篇名: 钙离子对全静脉营养液稳定性的影响
TITLE:
摘要: 目的:研究钙离子(Ca2+)对全静脉营养液(TPN)稳定性的影响,为临床使用提供依据。方法:按无菌操作规程配制4种Ca2+含量不同的TPN,在室温下,分别考察其在配制0、2、4、6、8、24 h各时间点的微生物限度、外观、pH值、渗透压摩尔浓度、不溶性微粒数及乳粒大小。结果:24 h内,各TPN均无菌落发育,外观无明显变化;各时间点、各TPN的pH值均>5,其差异均无统计学意义(P>0.05);各时间点、各TPN的渗透压摩尔浓度均在正常人体血液的渗透压摩尔浓度范围(280~310 mOsmol/kg)内,且差异均无统计学意义(P>0.05);随着Ca2+加入量的增加,各TPN中≥10 μm的不溶性微粒数呈增多趋势,差异有统计学意义(P<0.05);≥25 μm的微粒数变化不大,差异均无统计学意义(P>0.05);各时间点、各TPN中的乳粒粒径间的差异均有统计学意义(P<0.05)。结论:Ca2+会影响TPN的稳定性,主要表现为≥10 μm的不溶性微粒数增加,乳粒粒径增大。为保证TPN临床使用的安全性,应将TPN处方中二价阳离子的质量浓度控制在合理范围内,并在配制后尽快使用。
ABSTRACT: OBJECTIVE: To study the effects of calcium ion (Ca2+) on the stability of total parenteral nutrition (TPN), and to provide reference for clinical use. METHODS: 4 kinds of TPN containing different contents of Ca2+ were prepared according to sterile operation procedure, and at room temperature, their microbial limit, appearance, pH value, osmotic pressure molar concentration, the number of insoluble particle and emulsion particle size were investigated at 0, 2, 4, 6, 8 and 24 h. RESULTS: Within 24 h, no bacterial colony was found in TPN, and its appearance had no obvious change; pH value of TPN were all higher than 5 at different time points, without statistical significance (P>0.05); osmotic pressure molar concentration of TPN were all within the range of normal human blood (280-310 mOsmol/kg), without statistical significance (P>0.05). As the increase of Ca2+, the number of insoluble particle ≥10 μm in TPN showed increasing tendency, with statistical significance (P<0.05); that ≥25 μm had no significant change, without statistical significance (P>0.05). There was statistical significance in emulsion partial size of TPN at different time points (P<0.05). CONCLUSIONS: Ca2+ can influence the stability of TPN, manifesting as the number of insoluble particle ≥10 μm and emulsion partial size increase. To garantee the safety of TPN use in the clinic, the concentration of bivalent cation in TPN prescrption should be kept in reasonable range, and TPN should be used as soon as possible after preparation.
期刊: 2016年第27卷第17期
作者: 张文军,王斌,曹鹤菁
AUTHORS: ZHANG Wenjun,WANG Bin,CAO Hejing
关键字: 钙离子;全静脉营养液;稳定性
KEYWORDS: Calcium ion; Total parenteral nutrition; Stability
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