高渗氯化钠对失血性休克患者血清NO及CD18水平的影响  

Effect of Hypertonic Sodium Chloride on the Level of Serum NO and CD18 in Patients with Hemorrhagic Shock

作　　者：张玉景 李鹏 王为磊 张君利 杨舒立 ZHANG Yujing;LI Peng;WANG Weilei(Huaihai Hospital Affiliated to Xuzhou Medical University/The 97 Hospital of PLA,Jiangsu Xuzhou 221004,China)

机构地区：[1]徐州医科大学附属淮海医院/解放军第九七医院,江苏徐州221004

出　　处：《河北医学》2018年第4期604-608,共5页Hebei Medicine

基　　金：江苏省卫生厅科研项目;(编号:Z200912)

摘　　要：目的:研究高渗氯化钠治疗失血性休克患者的效果及对血清NO、CD18水平的影响。方法:选取我院2015年8月到2016年12月收治的失血性休克患者106例,采用分层随机分组法将其分为对照组和观察组,每组各53例。对照组患者接受静脉滴注纳洛酮注射液治疗,观察组患者在此基础上给予静脉滴注高渗氯化钠溶液治疗。比较两组患者的液体复苏情况、并发症发生情况及死亡情况,同时比较治疗前后血清一氧化氮(NO)和CD18水平的变化。结果:治疗后,观察组的血红蛋白(Hb)浓度明显高于对照组(P<0.01),输血量、复苏时间及平均动脉压(MAP)、血清NO和CD18水平、并发症总发生率和死亡率均明显低于对照组(P<0.05)。结论:高渗氯化钠联合纳洛酮治疗失血性休克的临床疗效显著,能够明显提高液体复苏质量、治疗安全性并改善患者预后,可能与其显著降低血清NO和CD18水平有关。Objective:To study the effect of hypertonic sodium chloride on the treatment of hemorrhagic shock and effect on serum levels of NO and CD18.Methods:106 cases with hemorrhagic shock who were treated in our hospital from August 2015 to December 2016 were selected and randomly divided into the control group and observation group with 53 cases in each group.The patients in the control group were treated with intravenous infusion of naloxone,while the patients in the observation group were treated with intravenous infusion of hypertonic sodium chloride on the basis of the control group.Then the fluid resuscitation,the incidence of complications and mortality,and the serum levels of nitric oxide(NO)and CD18 in the two groups were observed and compared before and after the treatment.Results:The concentration of Hb in the observation group was significantly higher than that of the control group(P<0.01),while the amount of blood transfusion,recovery time and MAP were significantly lower than those of the control group(P<0.01);After treatment,the serum levels of NO and CD18 in the observation group were significantly lower than those of the control group(P<0.01);The incidence of complications and mortality rate of the observation group were significantly lower than that of the control group(P<0.05).Conclusion:Hypertonic sodium chloride combined with naloxone in treatment of hemorrhagic shock has better clinical efficacy,which can significantly reduce the serum levels of NO and CD18,and decrease the incidence of complications and death,and it is worthy of clinical promotion.

关 键 词：高渗氯化钠 纳洛酮 失血性休克 一氧化氮 CD18 

分 类 号：R459.7[医药卫生—急诊医学]