比较复方电解质注射液(Ⅱ)与乳酸林格液对脓毒性休克患者液体复苏的效果  

Comparison of Multiple Electrolytes Injection(Ⅱ)and Lactated Ringer's Solution for Fluid Resuscitation in Patients with Septic Shock

作　　者：艾田逸 马林浩 AI Tian-yi;MA Lin-hao(Department of Emergency,the Affiliated Shanghai Changzheng Hospital of the Second Military Medical University,Shanghai 200003,China)

机构地区：[1]海军军医大学附属长征医院急救科,上海200003

出　　处：《实用临床医学（江西）》2018年第12期5-8,13,共5页Practical Clinical Medicine

摘　　要：目的探讨复方电解质注射液(Ⅱ)(商品名:瑞咯啶)与乳酸林格液对脓毒性休克患者液体复苏效果的影响。方法选取2015年8月至2016年1月住院治疗的48例脓毒性休克患者,按随机数字表法将其分为乳酸林格液组(R组,n=24)和瑞咯啶组(F组,n=24),R组首次复苏时于1h内输注患者3%体质量乳酸林格液。F组首次复苏时于1h内输注3%体质量瑞咯啶,其他处理相同。比较2组患者血气分析指标、液体复苏期间碳酸氢钠的用量。结果 F组乳酸水平较R组下降更明显(P<0.001),且F组随着复苏时间的延长下降更明显(P<0.001);碱剩余2组比较差异无统计学意义(P>0.05),但随着复苏时间的延长而上升(P<0.001),且F组上升更明显(P<0.001);标准碳酸盐值2组比较差异无统计学意义(P>0.05),且随着复苏时间的延长而变化(P<0.001),但变化的趋势差异无统计学意义(P=0.087)。液体复苏期间碳酸氢钠的使用量F组较R组明显减少[(105.3±26.6)mL比(159.1±29.8)mL,P=0.004]。结论瑞咯啶能显著降低脓毒性休克患者血乳酸水平,是脓毒性休克患者较有效的液体复苏选择。Objective To compare the effects of multiple electrolytes injection(Ⅱ)and lactated Ringer’s solution on fluid resuscitation in patients with septic shock.Methods Totally 48 patients hospitalized forseptic shock between during August 2015 and January 2016 were randomly given either 3% lactated Ringer’s solution(group R,n=24)or 3% multiple electrolytes in jection(Ⅱ)(group F,n=24)within 1 hour at the first resuscitation.Blood gas analysis indexes,and dosage of sodium bicarbonate were compared between two groups.Results Compared with group R,blood lactate level decreased in a time-dependent manner in group F(P<0.001).There were no significant differences in base excess value and standard carbonate value between the two groups.However,these two parameters increased with recovery time(P<0.001).Furthermore,the increase in base excess value in group F was more obvious than that in group R(P<0.001).Nevertheless,the increase in standard carbonate value was not different between the two group(P=0.087).During fluid resuscitation,the dosage of sodium bicarbonate in group F was lower than that in group R(105.3±26.6)mL vs(159.1±29.8)mL,P=0.004).Conclusion As an effective option for liquid resuscitation,multiple electrolytes injection(Ⅱ)can significantly decrease the blood lactate levels in patients with septic shock.

关 键 词：脓毒性休克 液体复苏 复方电解质注射液(Ⅱ) 乳酸林格液 血乳酸 

分 类 号：R459.7[医药卫生—急诊医学]