摘要
目的 探讨 7.5 %的小容量高渗盐水 (HS)对急性腹部闭合性创伤休克病人血清促炎性细胞因子的影响。方法 将 30例单纯急性腹部闭合性创伤、从受伤现场入救护车时收缩压均低于 90mmHg的成年病人 ,随机分为两组 :高渗盐水组 (HS组 ,n =15 )和乳酸钠林格式液组 (LR组 ,n =15 )。HS组于病人入救护车时立即静脉输注 7.5 %的HS ,按 4ml/kg体重的容量 5min内输完。LR组则用同种方法输注等容量的LR。然后用其它的血浆代用品或全血来复苏病人 ,所有病人均进行了急诊剖腹探查手术。并分别于输注HS或LR前即刻 (T1)、HS或LR输注后 1h(T2 )、术毕 (T3 )、和术后 2 4h(T4)各时点测定血清中肿瘤坏死因子 -α(TNF -α)、白细胞介素 - 6 (IL - 6 )和白细胞介素 - 8(IL - 8)的浓度。结果 HS组血清TNF -α ,IL - 6和IL - 8的浓度T1～T4各时点均显著低于LR组 (P <0 .0 1或 0 .0 5 )。结论 7.5 %的小容量HS可以有效抑制急性腹部创伤失血性休克病人促炎性细胞因子的合成和释放 ,预防全身炎症反应的发生。
Objective:To explore the effects of small-volume hypertonic saline (HS) on proinflammatory cytokine in shock patients following acute abdomen closed trauma and hemorrhage.Methods:30 adult shock patients following only acute abdomen closed trauma and hemorrhage, whose system blood pressures were below 90 mmHg when they were in ambulance, were randomly divided into two groups: hypersonic saline group (group HS, n=15), and Lactate Ringer s group (group LR, n=15). Patients in group HS received intravenous injection 7.5% HS 4 ml/kg within 5 min immediately. And patients in group LR received the equal amounts of LR and on the same methods. After that, other fluid replacement or blood was used to resuscitate all patients. All patients progressed the emergency panch exploration.Tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8) of serum were observed separately the moment before infusing HS or LR (T 1), 1 h after infusing HS or LR (T 2), at the end of operation (T 3), and 24 h after surgery (T 4) in two groups. Results:The levels of TNF-α,IL-6 and IL-8 of serum in group HS, were under significantly at T 1～ T 4, compared with group LR (P<0.01 or P<0.05). Conclusions:In resuscitating shock patients with acute trauma and hemorrhage, 7.5% HS can inhibit the production and release of proinfiammatory TNF-α,IL-6 and IL-8 of serum, and restrain system inflammatory response.
出处
《中国现代医学杂志》
CAS
CSCD
2004年第4期88-90,93,共4页
China Journal of Modern Medicine
关键词
高渗盐水
创伤失血性休克
促炎性细胞因子
hypertonic saline
traumatic and hemorrhagic shock
proinflammatory
