高渗氯化钠羟乙基淀粉40应用于失血性休克的研究

HYPERTONIC SODIUM CHLORIDE HYDROXYTHYL STARCH 40 INJECTION USED IN PATIENTS WITH HEMORRHAGIC SHOCK

目的探讨高渗氯化钠羟乙基淀粉40(HSH)对失血性休克的扩容效果。方法外伤致失血性休克患者70例,随机分成两组:高渗氯化钠羟乙基淀粉40组(H组),复方乳酸钠组(R组),每组各35例。H组患者30分钟内输注HSH10ml/kg,R组患者相同时间内输注Ringer’s10ml/kg。分别于输注前、输注结束和输注后30min三个时间点监测中心静脉压(CVP)、收缩压(SBP)、舒张压(DBP)、心率(HR)和血氧饱和度(SpO2),检测血浆Na+、Cl-、K+浓度。结果经快速扩容后,两组CVP、SBP、DBP、HR和SpO2较输注前均有改善,H组较R组改善更明显,差异有统计学意义(p<0.05)。H组钾离子轻度降低,钠离子和氯离子略有升高,但与R组比较无统计学差异。结论HSH(10ml/kg)应用于失血性休克患者,扩容效果较复方乳酸钠好。

Objective To investigate dilataney effect of the Hypertonic Sodium Chloride Hydroxythyl Starch 40 injection （HSH） for the treatment of hemorrhagic shock. Methods 70 eases with trauma induced hemorrhagic shock were randomly divided into two groups ： Hypertonie Sodium Chloride Hydroxythyl Starch 40 injection group （ H group）, Ringer＇s group （R group）, 35 eases in each group. Patients of H group were infused HSH10ml/kg within 30 minutes, the R group were infused Ringer＇ s 10ml/kg at the same time. Central venous pressure （CVP）, systolic blood pressure （SBP）, diastolic blood pressure （ DBP）, heart rate （HR） and oxygen saturation （ SpO2 ） were monitored before the infusion, after the infusion and finished 30 minutes separately. Na^＋ .Cl^- .K^＋ were examined before infusion and after infusion respectively. Results The CVP.SBP.DBP.HR and SpO2 in both groups were improved than before infusion, but those in H group is much better than R group, with statistical significance （p 〈 0. 05 ）. The potassium was reduced moderately and sodium ions and chloride ions were increased in H group than in R group, but it was still within normal range. Conclusion Appling HSH （10ml/kg） to patients with hemorrhagic shock can be better than the compound prescription of sodium lactate.