高渗氯化钠和胰岛素对多发性创伤的早期复苏临床分析  

Clinical analysis of hyperosmotic sodium chloride and insulin in the early recovery of multiple trauma

作　　者：叶安[1] 石斌[2] 

机构地区：[1]浙江省衢州市人民医院急诊科,浙江衢州324004 [2]兰州大学第一医院外科,甘肃兰州730000

出　　处：《中国现代医生》2014年第5期153-156,共4页China Modern Doctor

基　　金：高等学校博士学科点专项科研基金(20090211 120015)

摘　　要：目的探讨高渗氯化钠和胰岛素在多发伤救治中的作用。方法对我院2011年1月～2012年9月接诊的86例严重多发伤患者进行补充高渗氯化钠和胰岛素的治疗（为治疗组），治疗效果与2009年5月～2012年12月接诊的92例接受常规治疗的严重多发伤患者（为对照组）的治疗效果相比。结果治疗组患者血压上升时间、心率下降时间、尿量增加时间均明显短于对照组（P〈0．05），患者血清C-反应蛋白（CRP）、白细胞介素-6（IL-6）在治疗5d后明显下降（P〈0．05），肿瘤坏死因子（TNF—α）治疗24h后明显下降，且5d后下降更明显，均明显低于对照组患者水平（P〈0．05），治疗组病死率明显降低（P〈0．05）。结论给严重多发伤患者输注高渗氯化钠和胰岛素有益于患者早期复苏，降低患者血清CRP、IL-6、TNF—α水平，并降低患者病死率。Objective To investigate the effect of hypertonic sodium chloride and insulin in the treatment of multiple injuries. Methods A total of 86 patients with severe multiple trauma in our hospital from January 2011 to September 2012 （as treatment group） were treated with hypertonic sodium chloride and insulin supplement, and 92 patients with severe multiple trauma from May 2009 to December 2012 （as control group） received conventional therapy, then compared the treatment effect. Results Blood pressure rise time, heart rate down time, urine amount time of patients in the treatment group were significantly shorter than in the control group （P 〈 0.05）, serum C-reactive protein （CRP） and interleukin-6 （IL-6） decreased significantly in 5 days after treatment （P 〈 0.05）, tumor necrosis faetor-α（TNF-α treatment of 24h significantly decreased, and more obvious after 5 days, were significantly lower than that of the control group patients （P 〈 0.05）, mortality rate in the treatment group decreased significantly （P 〈 0.05）. Conclusion For patients with severe multiple trauma, the infusion of hypertonic sodium chloride and insulin is beneficial to early recovery, reducing serum CRP, IL-6 and TNF-α levels, and reducing the mortality of patients.

关 键 词：高渗氯化钠 胰岛素 多发伤 休克’ 

分 类 号：R641[医药卫生—外科学]