7.2%氯化钠加6%羟乙基淀粉200/0.5注射液用于创伤失血性休克复苏治疗的有效性与安全性评价  

Efficacy and safety evaluation of HyperHAES (7.2% saline/6% hydroxyethyl starch 200/0.5) for volume resuscitation of ccute traumatic hemorrhage shock

作　　者：赵钢[1] 吴蔚[1] 高海[1] 封启明[1] 

机构地区：[1]上海交通大学附属第六人民医院急诊科,上海200233

出　　处：《临床急诊杂志》2009年第4期214-217,共4页Journal of Clinical Emergency

摘　　要：目的:贺苏(7.2%氯化钠/6%羟乙基淀粉200/0.5注射液)用于创伤失血性休克的有效性与安全性。方法:48例急诊创伤性失血性休克患者随机分成7.2%氯化钠/6%羟乙基淀粉200/0.5注射液复苏组(实验组24例)和0.9%氯化钠/6%羟乙基淀粉200/0.5注射液复苏组(对照组24例),观察记录两组按4ml/kg初次复苏后30min内血流动力学变化,检测复苏前和观察终点时血常规、凝血功能、肝、肾功能、电解质指标,分析比较两组疗效(血压、休克指数)和安全性(血常规、凝血功能及生化指标变化)。结果:2组复苏后血压均明显升高,同时休克指数也均显著下降;实验组血压上升幅度及休克指数下降程度大于对照组;2组初次复苏后30min,红细胞(RBC)、血小板(PLAT)、血红蛋白(HB)、红细胞比积(HCT)均下降,凝血酶原时间(PT)、部分凝血活酶时间(KPTT)时间均延长,但其变化于2组间无显著差异;除实验组复苏后血CL轻度升高外,2组肝肾功能等生化指标于复苏前后均无显著变化。结论:贺苏(7.2%氯化钠/6%羟乙基淀粉200/0.5注射液)对低血容量性低血压复苏效率高,对于内环境无显著影响,可安全用于创伤失血性休克的救治。Objective： To evaluate the efficacy and safety of HyperHAES（7. 2% saline/ 6% hydroxyethyl starch 200/0.5） for volume resuscitation of acute traumatic hemorrhage shock. Method： Forty-eight trauma patients with hemorrhagic shock in emergency were randomly divided into the 7.2 % saline/ 6 % hydroxyethyl starch 200/0.5 resuscitation group （trial group, n = 24） and the 0.9 % saline/ 6 % hydroxyethyl starch 200/0.5 resuscitation group （control group, n =24）. By recording the changes of blood pressure （BP） and shock index （SI） within 30min after first resuscitation by 4ml/kg, and examining the blood routing test, the index of coagulation, hepatic function, renal function and electrolyte either before or after resuscitation 30min, the therapeutic efficacy （assessed by BP and SD and safety （evaluated by blood routing test, coagulation function and biochemical indicator） were analyzed. Result：After resuscitation, the haemodynamics was improved in both groups. But in the trial group, the BP increased higher, and SI decreased more significantly. At the 30min of resuscitation, red blood count, hemoglobin and haematocrit decreased while prothrombin time and partial thromboplastin time prolonged in both groups, but there were no significant differences between two groups. No significant changes of biochemical indicators were found after resuscitation 30min in both groups, except a little elevation of blood CL in the trial group. Conclusion： HyperHAES（7.2 % saline/6 % hydroxyethyl starch 200/0.5） is safe and more efficient for volume resuscitation of acute traumatic hemorrhage shock.

关 键 词：休克 出血性 贺苏 复苏 

分 类 号：R605.971[医药卫生—急诊医学]