目的：比较两种电解质维持液在阑尾切除术患儿术后的疗效，与低钠血症和水潴留的发生有关。
方法：一项随机临床研究，涉及50例接受阑尾切除术的儿科患者，随机接受2,000mL/m（2）/天的等渗（Na150mEq/L或0.9％NaCl）或低渗（Na30mEq/LNaCl或0.18％）溶液。电解质,葡萄糖，尿素,和肌酐在基线测量，24h,术后48h。注入量,利尿,体重,并对水平衡进行了分析。
结果：24例患者有初始低钠血症；在该组中，13收到低渗溶液。17例患者术后48h仍保持低钠血症，其中10人接受了低渗溶液。在这两组中,钠水平在24h时增加（137.4±2.2和137.0±2.7mmol/L），两者无显著性差异(p=0.593)。等渗组和低渗组术后48h钠水平分别为136.6±2.7和136.2±2.3mmol/L,分别,没有显著差异。在研究期间，两组之间的输注量和排尿量没有差异。接受低渗溶液的患者在手术前的水平衡较高（p=0.021）。
结论：在阑尾切除术后，使用低渗溶液(30mEq/L，与等渗盐水相比，0.18％）并未增加低钠血症的风险。使用等渗溶液(150mEq/L，0.9%）不赞成这些患者的高钠血症。接受低渗溶液的儿童在术前期间显示出更高的累积液体平衡。
OBJECTIVE: To compare two electrolyte maintenance solutions in the postoperative period in children undergoing appendectomy, in relation to the occurrence of hyponatremia and water retention.
METHODS: A randomized clinical
study involving 50 pediatric patients undergoing appendectomy, who were randomized to receive 2,000mL/m(2)/day of isotonic (Na 150 mEq/L or 0.9% NaCl) or hypotonic (Na 30 mEq/L NaCl or 0.18%) solution. Electrolytes, glucose, urea, and creatinine were measured at baseline, 24h, and 48h after surgery. Volume infused, diuresis, weight, and water balance were analyzed.
RESULTS: Twenty-four patients had initial hyponatremia; in this group, 13 received hypotonic solution. Seventeen patients remained hyponatremic 48h after surgery, of whom ten had received hypotonic solution. In both groups, sodium levels increased at 24h (137.4±2.2 and 137.0±2.7mmol/L), with no significant difference between them (p=0.593). Sodium levels 48h after surgery were 136.6±2.7 and 136.2±2.3mmol/L in isotonic and hypotonic groups, respectively, with no significant difference. The infused volume and urine output did not differ between groups during the
study. The water balance was higher in the period before surgery in patients who received hypotonic solution (p=0.021).
CONCLUSIONS: In the post-appendectomy period, the use of hypotonic solution (30 mEq/L, 0.18%) did not increase the risk of hyponatremia when compared to isotonic saline. The use of isotonic solution (150 mEq/L, 0.9%) did not favor hypernatremia in these patients. Children who received hypotonic solution showed higher cumulative fluid balance in the preoperative period.
