血浆代用品血定安应用于烧伤休克复苏的临床研究  

Clinical study of plasma substitute(Gelofusion) on fluid resuscitation in patients with burned shock

作　　者：赵晓东[1] 党伟[1] 何忠杰[1] 张宪[1] 闫柏刚[2] 姚咏明[1] 

机构地区：[1]解放军第三○四医院急救部,北京100037 [2]第三军医大学西南医院急救部,重庆400038

出　　处：《中国危重病急救医学》2003年第5期265-267,共3页Chinese Critical Care Medicine

基　　金：国家自然科学基金资助项目 ( 39870 2 86)

摘　　要：目的 :验证血浆代用品 (血定安 )在烧伤休克液体复苏中的临床疗效。方法 :2 0例烧伤总体表面积( TBSA)大于 40 %且因延迟复苏导致休克的烧伤患者 ,随机分为血定安复苏组 (血定安组 ,n=11)和血浆复苏组 (血浆组 ,n=9)进行复苏 ,观察休克期心排血量 ( CO)、氧供给 ( DO2 )、血细胞比容、血液黏度、血浆黏度、乳酸( L A)含量及碱缺失 ( BD)等血流动力学、血液流变学及氧代谢指标的变化。结果 :快速补液 2 h后 ,CO和 DO2显著升高 ( P<0 .0 5或 P<0 .0 1) ,血细胞比容、血液黏度、血浆黏度、L A和动脉血 BD显著下降 ( P<0 .0 5或P<0 .0 1)。两组间比较 ,伤后 2 4h内血定安组补液后血浆黏度显著低于血浆组 ( P均 <0 .0 5 ) ,其余指标无显著性差异 ( P均 >0 .0 5 )。结论 :在烧伤后休克复苏中 ,血浆代用品血定安与血浆的疗效相近 ,可以在烧伤休克早期救治中广泛应用。Objective:To investigate the effects of plasma substitute(Gelofusion,血定安) on fluid resuscitation in patients with burned shock.Methods:Twenty burn shock patients with total body surface area(TBSA) more than 40% were enrolled for clinical study on the effect of resuscitation with plasma substitute(Gelofusion).The patients were randomly divided into two groups:Gelofusion resuscitation group(n=11)and plasma resuscitation group(n=9).The cardiac output(CO),oxygen delivery(DO 2),packed cell volume(PCV),blood and plasma viscosity,lactate(LA) and base deficit(BD) levels were detected at shock stage(postburn from 1 to 48 hours).Results:Two hours after rapid fluid replacement,the levels of CO and DO 2 were gradually increased,while the levels of PCV,blood and plasma viscosity,LA and BD were markedly decreased(P<0.05 or P<0.01).After resuscitation,plasma viscosity in Gelofusion resuscitation group were obviously lower than that in plasma resuscitation group within 24 hours postburn(all P<0.05).With an exception of plasma viscosity,there were no significant differences in other parameters between two groups at various intervals (all P>0.05).Conclusion:In the resuscitation of burn shock,the clinical effects of Gelofusion treatment is similar to that of plasma treatment.Gelofusion appears to be a fairly good plasma substitute for extensive application on the management of burn shock during the early stage.

关 键 词：血浆代用品 血定安 烧伤 休克 复苏 疗效 

分 类 号：R644[医药卫生—外科学] R969[医药卫生—临床医学]