晶体联合胶体液在低血容量性休克急救中的应用  

Application of crystalloid combined colloid solution in emergency treatment of hypovolemic shock

作　　者：周世泰[1] 陈尚扣 黄仁春[1] 

机构地区：[1]陕西省汉中市中心医院急诊科,汉中723000

出　　处：《陕西医学杂志》2017年第12期1642-1643,1646,共3页Shaanxi Medical Journal

基　　金：陕西省科技攻关项目[2014K11(03-02-06)]

摘　　要：目的:探讨晶体联合胶体液在急救低血容量性休克患者的应用价值。方法:选择90例低血容量休克患者,按照随机数字表法分为两组,对照组45例,实施单纯输注晶体液进行急救治疗,观察组45例,使用晶体联合胶体液进行急救治疗,比较两组患者的病死率和输液量,血压恢复情况,全身性感染相关性器官功能衰竭(SOFA)评分,以及心率,乳酸值,尿量的变化情况。结果:对照组患者的病死率为57.78%,高于观察组的病死率20.00%(P<0.05);对照组患者的输液量远多于观察组(P<0.05);观察组患者的血压回升速度显著快于对照组患者(P<0.05);输液前两组患者的SOFA评分无差别(P>0.05),输液后观察组患者的SOFA评分为6.12±1.57,对照组为8.85±3.05,两组比较差异具有统计学意义(P<0.05);输液30min,两组患者较输液前心率减慢,尿量增多,乳酸值降低,且观察组比对照组变化明显(P<0.05)。结论:晶体联合胶体液对低血容量性休克患者进行急救较单独应用晶体可很快的恢复患者的血压,降低病死率,改善病情,具有更好的临床效果。Objective:To explore the clinicalvalue of crystalloid combined with colloidal solutionin the emergency treatment of patients with hypovolemic shock.Methods:90 patients withhypovolemic shockwere selected and divided into two groups according to random number table method.45 cases in control group were treated with crystalloid solution,and in observation group,45 caseswere treated with crystalloid combined colloidal solution.The fatality rate and transfusion volume,blood pressure recovery,systemic infection related organ failure(SOFA)score,heart rate,lactic acid value and urine volume were compared between the two groups.Results:The fatality rate in control group(57.78%)significantly higher than the observationgroup(20.00%)(P<0.05).The transfusion volume of the control group was much higher than that of the observation group(P<0.05).The blood pressure recovery rate of the observation group was significantly faster than that of the control group(P<0.05).The difference of SOFA scores between the two groups after infusion is statistically significant(control group(8.85±3.05)vs observation group(6.12±1.57).After the infusion of 30 min,two groups of patients were slow heart rate,increased urine output,and decreased lactic acid value.The observation group was significantly changed compared with the control group(P<0.05).Conclusion:The combination of crystalloid and colloid solution in emergency treatment of hypovolemic shock patients could recover the blood pressure,reduce the fatality rate and improve the patient's condition,and have better clinical effect.

关 键 词：休克 晶体液 @胶体液 急救 

分 类 号：R605[医药卫生—外科学]