限制性液体复苏对失血性休克复苏患者血浆TNF-α、IL-6水平的影响  

Effect of Limited Fluid Resuscitation on Plasma TNF-α and IL-6 Levels in Patients with Hemorrhagic Shock Resuscitation

作　　者：杨嘉琳[1] 池凯仪[1] 龙振鸿 徐文婷[1] 徐仲[1] 

机构地区：[1]广州医科大学附属第三医院/广州重症孕产妇救治中心重症医学科,广东广州510150

出　　处：《现代生物医学进展》2016年第13期2513-2515,共3页Progress in Modern Biomedicine

基　　金：广州市医药卫生科技项目(20151A010105)

摘　　要：目的：探究限制性液体复苏对失血性休克复苏患者血浆肿瘤坏死因子（TNF-α）、白细胞介素-6（IL-6）水平的影响,为临床治疗失血性休克选择液体复苏方式提供依据。方法：选择2010年1月~2015年6月期间,我院收治出血性休克患者63例为研究对象;采用随机数字法将其分为观察组（32例）和对照组（31例）,观察组患者给予限制性液体复苏,对照组患者给予传统充分复苏;观察并比较两组患者治疗前后血浆TNF-α、IL-6水平的变化。结果：观察组患者给予复苏液体的输入量为（1.95±0.35）L,对照组患者给予输液量为（3.61±0.56）L,观察组患者给予的复苏液输入量显著低于对照组,差异具有统计学意义（P〈0.05）;治疗前两组患者血浆TNF-α及IL-6水平不存在显著差异（P〉0.05）;治疗后两组患者血浆TNF-α及IL-6水平均显著上升,且观察组患者血浆TNF-α及IL-6水平均显著低于对照组,差异具有统计学意义（P〈0.05）。结论：限制性液体复苏能够明显降低失血性休克患者的出血量,稳定机体血流动力学,保证机体重要脏器的血流灌注,有利于改善患者血浆TNF-α和IL-6水平,提高治疗效果,改善预后。Objective： To explore the effect of limited fluid resuscitation on plasma tumor necrosis factor-α （TNF-α） and inter- leukin-6（IL-6） levels in patients with hemorrhagic shock resuscitation, to provide the basis for clinical treatment of hemorrhagic shock in the choice of liquid recovery. Methods： Selected 63 cases of patients with hemorrhagic shock in our hospital from January 2010 to June 2015 as the research object; Which were divided into observation group（32 patients） and control group （31 patients） by random number table method, the patients in observation group was given a limited fluid resuscitation, and the patients in control group received traditional full recovery; Observed and compared the changes of plasma TNF-α and IL-6 levels in two groups before and after treatment. Results： The input of recovery fluid of the patients in the observation group was（1.95 ± 0.35） L, which was significant higher than （3.61 ± 0.56）L of control group, the difference was statistically significant（P〈0.05）; There was no significant difference in plasma TNF-α and IL-6 levels between the two groups before treatment（P〉0.05）; The plasma levels of TNF-α and IL-6 in the two groups were significantly in- creased, and plasma TNF-α and IL-6 levels in the observation group were significantly lower than those in the control group after treat- merit, the difference was statistically significant（P〈0.05）. Conclusion： Limited fluid resuscitation can significantly reduce the amount of bleeding in patients with hemorrhagic shock, stabilize the blood flow dynamics and ensure the blood flow of the important organs of the body; It is beneficial to improve the level of plasma IL-6 and TNF-α in patients,improve the therapeutic effect and improve prognosis.

关 键 词：限制性液体复苏 失血性休克复苏 TNF-Α IL-6 

分 类 号：R605.971[医药卫生—急诊医学]