摘要
目的观察小容量高渗晶体等渗胶体混合溶液对创伤失血性休克患者的早期容量复苏效果。方法将我科收治的48例早期轻、中度创伤失血性休克患者,随机分为两组,每组24例。通过外周血管在15～20 min 内快速输注250ml 研究药物(贺苏,7.2%氯化钠/6%羟乙基淀粉200/0.5注射液)或对照药物(贺斯,0.9%氯化钠/1%羟乙基淀粉200/0.5溶液)。在给药前、给药后0.5、10、15、20、25、30 min 测定患者的血压、脉搏和休克指数;在研究开始前和给药后30 min 各采集1次外周血样本,并检测血常规、血 Na^+、Cl^-和凝血常规。结果研究组收缩压在给药后0、5、10、15、20、25、30 min 均显著高于对照组(P<0.01),舒张压在给药后0、5、10、15 min 内均显著高于对照组(P<0.05),休克指数在给药后均显著低于对照组(P<0.05)。研究组在给药后血 Na^+、Cl^-高于对照组(P<0.01),但其平均浓度在正常参考值范围内。研究组与对照组凝血功能、血常规指标差异均无统计学差异。结论小容量高渗晶体等渗胶溶液在创伤失血性休克患者早期血流动力学快速恢复作用上有良好的效果且安全性良好。
Objective To observe the effects of small-volume hyperosmotic crystalloid and isoosmotic colloidal solution in recovery of the early traumatic hemorrhagic shock. Methods 48 cases of early and mid-traumatic hemorrhagic shock patients were randomly divided into 2 groups, the experimental group（ n = 24） and control group （ n = 24）. The experimental group received a rapid intravenous（IV） infusion of 250 ml of the hyperosmotic crystalloid and isoosmotic colloidal solution（7.2% sodium chloride/Hes 200/0. 5 solution, Fresenius Kebi） within 15 - 20 minutes. In the control group, only the studied drug were replaced by the control drug（ HAES,0. 9% solution chloride/6% Hes 200/0. 5 solution, Fresenius Kabi） . The blood pressure, pulse and shock index of the patients were recorded before and 0,5,10,15,20,25,50 min after the drug transfusion. Blood routine, serum Na^ ＋ and Cl^ - indices and conventional coagulation assays were performed before and 30 min after the administration. Results Systolic pressure in the experimental group was significantly higher than the control group at 0,5,10,15,20,25,30 min after the transfusion （ P 〈 0. 01 ）, and diastolic pressure in the experimental group was significantly higher than the control group in 0,5,10,15 rain after transfusion. The shock index in the experimental group was lower than the control group after transfusion （ P 〈 0. 05 ）. The serum sodium and chloride concentration in experimental group were significantly higher than the control group at each recording time after the transfusion （ P 〈 0. 01 ）, but they were in normal range. There were no statistical difference between the two groups with respect to coagulation function, blood routine items. Conclusion Rapid recovery of hemodynamic can be achieved by the small - volume hyperosmotic crystalloid and isoosmotic colloidal solution in the early stage of traumatic hemorrhagic shock, and the solution is also safe in clinic.
出处
《临床急诊杂志》
CAS
2008年第4期199-201,共3页
Journal of Clinical Emergency
关键词
创伤
休克
容量复苏
胶体
高渗晶体
Trauma
Shock
Volume Resuscitation
Colloid
Hypertonic crystalloid
