限制性液体复苏法在产后失血性休克孕妇中的应用及对失血量、血IL-18、MDA、microRNA-155和Treg细胞水平的影响  

Application Value of Limited Fluid Resuscitation on Pregnant Women with Postpartum Hemorrhagic Shock and Its Influence on Blood Loss,Blood IL-18,MDA,MicroRNA-155 and Treg Cells

作　　者：盛雅倩[1] 魏乔[1] SHENG Yaqian;WEI Qiao(The First Affiliated Hospital of Xiamen University,Xiamen 361022,China)

机构地区：[1]厦门大学附属第一医院,福建厦门361022

出　　处：《中外医学研究》2018年第15期1-3,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探究限制性液体复苏法在产后失血性休克(HS)孕妇中的应用及对失血量、血白介素-18(IL-18)、丙二醛(MDA)、微小核糖核酸-155(microRNA-155,miR-155)和调节性T细胞(Treg)水平的影响。方法:将诊治的78例产后HS患者采用简单随机法分为研究组和对照组,每组39例。对照组行常规复苏,研究组行限制性液体复苏法(LFR)。观察两组治疗效果[出血量、输血量、输液量、复苏时间、多器官功能障碍综合征(MODS)发生率],评估复苏前后两组疾病相关指标水平(IL-18、MDA、miR-155和Treg)。结果:研究组出血量、输血量、输液量、复苏时间及MODS发生率均小于对照组(P<0.05);复苏后,研究组较对照组IL-18、MDA、treg细胞水平低,较对照组miR-155水平高,差异均有统计学意义(P<0.05)。结论:LFR是救治产后HS孕妇一种安全有效的手段,能够减少患者出血量和复苏时间,同时优化各炎症、免疫、氧化应激指标水平,改善患者预后状况。Objective：To explore the application value of limited fluid resuscitation on pregnant women with postpartum hemorrhagic shock（HS）and its influence on blood loss,blood interleukin-18（IL-18）,malondialdehyde（MDA）,microRNA-155（miR-155） and treg cells（Treg）.Method：78 postpartum HS patients were divided into study group（39 cases） and control group（39 cases） by simple random method.The control group was given routine resuscitation,while the study group was given limited fluid resuscitation（LFR）.The therapeutic effects including blood loss,blood transfusion volume,fluid transfusion volume,recovery time and incidence of multiple organ dysfunction syndrome（MODS） in the two groups were observed,and the levels of disease related indicators（IL-18,MDA, miR-155 and treg） in the two groups were evaluated before and after resuscitation.Result：The blood loss,blood transfusion volume,fluid transfusion volume,recovery time and incidence of MODS in the study group were all less than those in the control group（P〈0.05）.After resuscitation,the levels of IL-18,MDA and treg cells in the study group were all lower than those in the control group（P〈0.05）,but the level of miR-155 in the study group was higher than that in the control group（P〈0.05）.Conclusion：LFR is safe and effective for postpartum HS patients,can not only reduce the amount of bleeding and recovery time,but also optimize the levels of inflammation,immune and oxidative stress,and improve the prognosis of patients.

关 键 词：限制性液体复苏 充分液体复苏 产后 失血性休克 

分 类 号：R714[医药卫生—妇产科学]