醋酸钠林格液与乳酸钠林格液用于创伤性失血性休克患者的疗效比较  

Comparison of efficacy between sodium acetate Ringer′s solution and sodium lactate Ringer′s solution in patients with traumatic hemorrhagic shock

作　　者：王家海[1] 杨春 王桂林[1] WANG Jia-hai;YANG Chun;WANG Gui-lin(Department of Emergency,the Second People′s Hospital of Yibin City,Sichuan Province,Yibin 644000,China;Department of Cardiology,the First People′s Hospital of Yibin City,Sichuan Province,Yibin 644000,China)

机构地区：[1]四川省宜宾市第二人民医院急诊科,四川宜宾644000 [2]四川省宜宾市第一人民医院心内科,四川宜宾644000

出　　处：《河北医科大学学报》2023年第8期929-933,共5页Journal of Hebei Medical University

基　　金：四川省科技计划项目(2019CXRC0027)。

摘　　要：目的探讨醋酸钠林格液与乳酸钠林格液用于创伤性失血性休克患者的疗效。方法选取创伤性失血性休克患者54例作为研究对象,按随机数字表法分为观察组和对照组,各27例。观察组复苏液体采用醋酸钠林格液,对照组复苏液体采用乳酸钠林格液,复苏方法均采用限制性液体复苏。比较2组患者复苏时间、输液总量及平均动脉压。分别于复苏前、液体复苏30 min及复苏1 h抽取外周静脉血,检测白细胞介素(interleukin,IL)-4、IL-6、IL-10、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)水平以及动脉血的乳酸值(lactic acid,Lac)、外周血小板计数(platelet,PLT)、血浆凝血酶原时间(prothrombin time,PT)、纤维蛋白原(fibrinogen,FIB)水平。结果观察组复苏时间、输液总量显著少于对照组,平均动脉压显著低于对照组(P<0.05)。2组Lac呈逐渐降低趋势,观察组Lac水平低于对照组,组间,时点间、组间·时点间交互作用差异有统计学意义(P<0.05)。2组PLT、FIB呈逐渐降低趋势,PT呈逐渐升高趋势,时点间差异有统计学意义(P<0.05),组间,组间·时点间交互作用差异无统计学意义(P>0.05)。2组IL-4、IL-6、IL-10、TNF-α水平均呈逐渐升高趋势,观察组IL-4、IL-10水平高于对照组,IL-6、TNF-α水平低于对照组,组间、时点间差异有统计学意义(P<0.05),组间·时点间交互作用差异无统计学意义(P>0.05)。结论创伤性失血性休克患者早期使用醋酸钠林格液较乳酸钠林格液能更好地抑制外周血炎症因子的表达,进一步降低血Lac水平。Objective To explore the efficacy of sodium acetate Ringer′s solution and sodium lactate Ringer′s solution in patients with traumatic hemorrhagic shock(THS).Methods A total of 54 patients with THS were selected as the research subjects and randomly divided into an observation group(n=27)and a control group(n=27)using a random number table method.The observation group was resuscitated with sodium acetate Ringer′s solution,while the control group was resuscitated with sodium lactate Ringer′s solution.The resuscitation methods all involved restricted liquid resuscitation.Duration of resuscitation,total infusion volume,and mean arterial pressure(MAP)were compared between two groups.Peripheral venous blood was drawn before resuscitation,at 30 min after fluid resuscitation and at 1 h after resuscitation to detect the levels of interleukin(IL)-4,IL-6,IL-10 and tumor necrosis factorα(TNF-α)and lactic acid(Lac)value of arterial blood,peripheral platelet(PLT)count,plasma prothrombin time(PT),and fibrinogen(FIB)level.Results The duration of resuscitation and total infusion volume in the observation group were significantly shorter than those in the control group,and MAP was significantly lower than that in the control group(P<0.05).The Lac levels in the observation group were gradually decreased compared to those in the control group,and there was a significant difference in the interaction between groups,time points,and time points between groups(P<0.05).The PLT and FIB of the two groups showed a gradually decreasing trend,while the PT showed a gradually increasing trend;the difference between time points was statistically significant(P<0.05),but there was no significant difference in the interaction between groups or time points between groups(P>0.05).The levels of IL-4,IL-6,IL-10,and TNF-αin both groups showed a gradual upward trend;the levels of IL-4 and IL-10 in the observation group were higher,but the levels of IL-6 and TNF-αwere lower,as compared with those in the control group,and there was a significan

关 键 词：休克 创伤性 醋酸钠林格液 乳酸钠林格液 

分 类 号：R605.971[医药卫生—急诊医学]