高渗氯化钠羟乙基淀粉40注射液在创伤病人手术的应用

Clinical observation on hyperonic sodium chloride hydroxyethyl starch 40 injection in traumatic patients

目的研究高渗氯化钠羟乙基淀粉40注射液(以下简称:高渗晶胶液)用于创伤病人手术的有效性和安全性。方法创伤评分(ISS)13～15分病人50例,随机分为高渗晶胶液组(H组)和复方氯化钠组(R组),每组25例。两组病人均采用静吸复合麻醉,诱导时依次静注芬太尼1～2μg/kg、阿曲库铵0.25～0.5mg/kg、丙泊酚2mg/kg、气管插管后行机械控制呼吸,麻醉维持吸入0.5%～1%异氟醚,微量泵持续灌注阿曲库铵0.25～0.5mg·kg-1·h-1、丙泊酚2.5～5mg·kg-1·h-1。H组:术前输入高渗晶胶液250ml,输注速度10ml·kg-1·h-1;R组:常规输入复方氯化钠。于给药前和停药后30min检测血气,观察并记录Na+、Hct,观察并记录给药前、给药后5、10、15、20、25min和停药后30min的SBP、DBP、MAP、HR。术前放空尿袋,观察并记录停药后30min两组尿量。结果给药后5、10、15、20、25min和停药后30min,H组SBP、DBP、MAP均明显高于给药前和R组(P<0.05),HR慢于给药前和R组(P<0.05)。停药后30min,H组Hct明显高于给药前(P<0.05)。H组尿量明显高于R组(P<0.05)。H组未发现恶心、呕吐、皮肤潮红等不良反应。

Objective To study the effects and safety of hypertonic sodium chloride hydroxyethyl starch 40 injection（HSH 40） in traumatic patients. Methods Fifty traumatic patients were randomly divided into HSH 40 group （H） and Ringre＇s solution infusion group （R）. Anesthesia was induced with intravenous injection of fantanyl 1-2/μg/kg,atracurium 0.25-0. 5 mg/kg,propfol 2 mg/kg. In group H, HSH 40 250 ml was infused in a rate of 10 ml/h,and Ringer＇s solution was infused instead of HSH 40 in group R. Arterial blood samples were taken before injection and at 30 min after injection. Hct and urine output were recorded. SBP,DBP, MAP and HR were recorded befor injection and at 5,10,15,20,25 min during infusion and at 30 min after injection. Result SBP,DBP, MAP at 5,10,15,20,25 min during infusion and at 30 min after infusion were significantly higher in group H than those before injection and in group R（P〈0.05）. HR was lower in group H than that in group R（P〈0.05）. Urine output in group H was remarkably more than that in group R（P〈0.05）. Conclusion HSH 40 can be used effectively and safely in traunatic patients.