碳酸氢钠林格液限制性复苏治疗创伤性失血性休克对血气分析指标、TEG参数的影响  

The Effect of Sodium Bicarbonate Ringer's Limited Resuscitation on Blood Gas Analysis Indicators and TEG Parameters with Traumatic Hemorrhagic Shock

作　　者：王文坤 WANG Wenkun(Emergency Department of Putian 95th Hospital,Putian 351100,Fujian)

机构地区：[1]莆田九十五医院急诊科,福建莆田351100

出　　处：《中华灾害救援医学》2024年第8期877-880,共4页Chinese Journal of Disaster Medicine

摘　　要：目的探讨碳酸氢钠林格液限制性复苏治疗对创伤性失血性休克患者的影响。方法回顾性分析2021年10月至2023年10月我院收治的78例创伤性失血性休克患者的临床资料,按照治疗方式的不同进行分组,其中予以乳酸钠林格液限制性复苏治疗的39例患者为对照组,予以碳酸氢钠林格液限制性复苏治疗的39例患者为观察组。比较两组炎性因子、血气分析指标、血栓弹力图(TEG)参数。结果观察组治疗后白介素-10(IL-10)、白介素-4(IL-4)、颈动脉球血氧饱和度、pH值、血凝块最大硬度或强度(MA)均显著高于对照组(P<0.05);肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、白细胞介素1β(IL-1β)、动脉血乳酸、血凝块形成时间(K)、凝血反应时间(R)均低于对照组(P<0.05)。结论碳酸氢钠林格液限制性复苏治疗效果更佳,能够有效抑制炎症因子表达,调节血气分析指标、TEG参数。Objective To investigate the effects of restrictive resuscitation with sodium bicarbonate Ringer's solution on patients with traumatic hemorrhagic shock.Methods A retrospective analysis was conducted on the clinical data of 78 patients with traumatic hemorrhagic shock treated at our hospital from October 2021 to October 2023.The patients were divided into two groups based on the treatment method:the control group(39 patients)received restrictive resuscitation with lactated Ringer's solution,while the observation group(39 patients)received restrictive resuscitation with sodium bicarbonate Ringer's solution.The inflammatory factors,blood gas analysis parameters,and thermo-electric generation(TEG)parameters were compared between the two groups.Results After treatment,the observation group had significantly higher levels of interleukin-10(IL-10),interleukin-4(IL-4),carotid bulb oxygen saturation,pH value,and maximum clot firmness(MA)compared to the control group(P<0.05).Tumor necrosis factor-alpha(TNF-α),interleukin-6(IL-6),interleukin-1β(IL-1β),arterial blood lactate,clot formation time(K),and reaction time(R)were lower in the observation group compared to the control group,with statistically significant differences(P<0.05).Conclusion Restrictive resuscitation with sodium bicarbonate Ringer's solution shows better therapeutic effects,effectively inhibiting the expression of inflammatory factors,and regulating blood gas analysis parameters and TEG parameters.

关 键 词：休克 创伤性 限制性复苏 碳酸氢钠林格液 

分 类 号：R749.054[医药卫生—神经病学与精神病学]