霍姆复合液在创伤性休克院前急救中的应用研究  

Study on the application of Hypertonic Sodium Chloride Hydroxyethyl Starch 40 Injection on the acute traumatic shock

作　　者：李伟[1] 张思森[1] 刘青[1] 王玲[1] 王国涛[2] 刘变化[3] 

机构地区：[1]南方医科大学附属郑州人民医院急救医学中心,450003 [2]南方医科大学临床医学系,广州510515 [3]新乡医学院临床医学系,453003

出　　处：《中华灾害救援医学》2014年第11期625-628,共4页Chinese Journal of Disaster Medicine

基　　金：河南省郑州市科技攻关计划项目(20130595);河南省郑州市科技领军人才计划项目(131PLJRC682)

摘　　要：目的观察霍姆复合液(hypertonic sodium chloride hydroxyethyl starch 40 injection,HSH40)对急性创伤性休克患者容量复苏的临床效果。方法选取急诊救治的45例急性创伤性休克患者为研究对象,均采用限制性容量复苏,根据复苏液体的不同将患者分成3组。A组给予晶体(0.9%氯化钠注射液)与胶体(羟乙基淀粉注射液),比例为2∶1;B组给予HSH40;C组仅给予0.9%氯化钠注射液。监测3组患者复苏前后活化凝血酶原时间(activated partial thromboplastin time,APTT)、动脉血乳酸(lactic acid,LA)、氧合指数(oxygenation index,OI)等指标,并进行对比分析。结果 B组患者平均复苏液体输入量为(1300±60)ml,显著低于A组(1500±55)ml和C组(1650±40)ml,差异具有统计学意义(P<0.05)。3组患者复苏1 h后部分APTT、LA、OI比较,B组显著低于A、C两组,差异有统计学意义(P<0.05)。此外,B组并发症构成与C组的差异有统计学意义(P=0.001)。结论霍姆复合液对急性创伤性休克患者早期复苏效果明显,能迅速改善患者的休克状态。Objective To observe and analyze the therapeutic effect of Hypertonic Sodium Chloride ttydroxyethyl Starch 40 Injection （HSH40） on the acute traumatic shock patients. Methods 45 cases with the acute tramnatic shock were randomly divided into three groups： group A （usage of 0.9% sodium chloride and hydroxyethyl starch injection）, the ratio of which was 2： 1; group B （usage of HSH40）, group C （usage of 0.9% sodium chloride injection）. Restrictive fluid resuscitation was used for all three groups. Activated partial thromboplastin time（ AffI＇Y）, lactic acid（LA） and oxygenation index （OI） were measured before and after treatment. Results The average recovery liquid of patients in group B was （ 1300 ~ 60） ml, which was remarkably lower than that of group A （1500 ＋ 55 ） ml and group C （1650 ＋40） ml （P 〈 0.05 ）. There were significant statistic difference in the comparison of AV1T, LA and OI among the three groups （ P 〈 0.05 ）. The difference of complication constitute between group B and C was significant （ P = 0.001 ）. Conclusions HSH40 has a good effect on early resuscitation of patients with acute traumatic shock, and can rapidly improve the shock state of patients.

关 键 词：HSH40 创伤 休克 限制性液体复苏 

分 类 号：R459.7[医药卫生—急诊医学]