中西医结合治疗对严重多发伤伴创伤失血性休克早期液体复苏效果及血液流变学、炎性因子和早期肾功能损害的影响  

Effect of Xuebijing combined with anisodamine on early fluid resuscitation,hemorheology,inflammatory factors and early renal injury in severe multiple trauma with traumatic hemorrhagic shock

作　　者：黄仁春[1] 周世泰[1] 马飞[1] HUANG Renchun, ZHOU Shitai, MA Fei(Hanzhong Central Hospital, Hanzhong 723000, Shaanxi, Chin)

机构地区：[1]陕西省汉中市中心医院,陕西汉中723000

出　　处：《现代中西医结合杂志》2018年第19期2072-2076,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察血必净联合山莨菪碱对严重多发伤伴创伤失血性休克患者早期液体复苏的效果及血液流变学、炎性因子和早期肾功能损害的影响。方法将80例严重多发伤伴创伤失血性休克患者随机分为观察组40例和对照组40例,对照组给予早期液体复苏治疗,观察组在对照组治疗基础上给予血必净注射液+山莨菪碱治疗,连续治疗48h。观察2组治疗前及治疗后6 h、12 h、24 h、48 h循环系统和组织灌注氧代谢、血液流变学、炎性因子和早期肾功能的变化情况。结果 2组治疗后6 h、12 h、24 h、48 h的Scv(O2)、乳酸、pH值均显著改善(P均<0.05),血浆黏度、红细胞聚集指数、血沉、血细胞比容及血浆白细胞介素-6(IL-6)、IL-10、肿瘤坏死因子-α(TNF-α)水平均显著降低(P均<0.05),且观察组各指标改善情况均显著优于对照组(P均<0.05);2组治疗后24 h、48 h的血肌酐(Cr)、尿素氮(BUN)水平均较治疗前明显降低(P均<0.05),尿N-乙酰-β-D氨基酸葡萄糖苷酶(NAG)水平在治疗后6 h、12 h、24 h、48 h均显著降低(P均<0.05),观察组上述指标均显著低于对照组(P均<0.05)。结论血必净联合山莨菪碱能够提高严重多发伤伴创伤失血性休克患者早期液体复苏的效果,改善血液流变学指标,降低炎性因子水平,对损伤的肾脏组织具有保护效应。Objective It is to observe the effects of Xuebijing combined with anisodamine on early fluid resuscitation and hemorheology,inflammatory factors and early renal impairment in patients with severe traumatic with traumatic hemorrhagic shock. Methods Eighty patients with severe multiple trauma and traumatic hemorrhagic shock were randomly divided into observation group（ 40 cases） and control group（ 40 cases）. The control group was treated with early fluid resuscitation and the observation group was continuously treated for 48 h with Xuebijing injection ＋ anisodamine on the basis of the control group. The changes of circulatory system and tissue oxygen metabolism,hemorheology,inflammatory factors and early renal function before and treatment for 6 h,12 h,24 h and 48 h. Results The levels of Scv（ O2）,lactic acid and p H at 6 h,12 h,24 h and 48 h after treatment were significantly improved（ P〈0. 05）,plasma viscosity,erythrocyte aggregation index,ESR,hematocrit and plasma IL-6,IL-10 and TNF-α were decreased significantly,and the improvement of each index in the observation group was better than that of the control group（ P〈0. 05）. Compared with that before treatment in both groups,the blood Cr and BUN were significantly lower after treatment for 24,48 h and urinary NAG for 6 h,12 h,24 h,and 48 h after treatment（ P〈0. 05）. The above indexes in the observation group were lower than those in the control group（ P〈0. 05）. Conclusion Xuebijing combined with anisodamine can improve the effect of early fluid resuscitation,improve hemorheology,inhibit inflammatory factors,and have protective effect on injured kidney tissue in patients with severe multiple traumatia with traumatic hemorrhagic shock.

关 键 词：血必净注射液 山莨菪碱 多发伤 创伤失血性休克 液体复苏 血液流变学 

分 类 号：R64[医药卫生—外科学]