7.5%高渗盐水用于创伤性失血性休克早期复苏的观察

The Effects of the Fluid Resuscitation Methods in the Treatment of Patients with Hemorrhagic Traumatic Shock

目的:探讨7.5%高渗盐水对创伤性失血性休克的救治效果。方法:对80例失血性休克患者分别输注高渗盐水和生理盐水。高渗盐水组43例,生理盐水组37例,比较2组病例的输入液体量、复苏前后的血清乳酸值、碱剩余值、治愈率、死亡率和MODS发生率。结果:2组液体输入量、复苏后12 h及24 h血乳酸、碱剩余检测值差异有显著性差异(P<0.05),2组治愈率、死亡率、发生MODS率有显著性差异(P<0.05)。结论:采用7.5%高渗盐水早期复苏方法治疗创伤性失血性休克可明显增加有效循环血量,改善组织器官灌注,提高治愈率,降低死亡率和MODS发生率,治疗效果明显优于常规生理盐水复苏方法。

Objective： To discuss 7. 5% hypertonic saline fluid resuscitation in the treatment of hemorrhagic traumatic shock （HTS）. Methods： 80 cases of hemorrhagic traumatic shocks were divided into two groups, the hypertonic saline solution resuscitation group was 43 and the conventional resuscitation group was 37. The input quantity, the level of lactic acid and base excess before and after the resuscitation and the cure rate, mortality, MODS incidence were analysed. Results：There were no significant differences in the lactic acid and the base excess before the resuscitation between the two groups（P 〉0.05）. The input quantity, the value of lactic acid and base excess in 12 h resuscitation and 24 h resuscitation were significant difference in two groups （P 〈 0.05 ）. 25 patients （67.6%） were cured, and 12 patients died （32.4%） and 14 （37.8%） patients were MODS in the conventional resuscitation group. But in the hypertonie saline group ,37 patients （86.0%） were cured, and 6 patients （ 14.0% ） died and 7 （ 16.3% ） patients were MODS. The differences of the cure rate, mortality, and MODS incidence between the two groups were significant （P 〈 0.05 ）. Conclusion： 7.5% hypertonic saline solution resuscitation in the treatment of hemorrhagic traumatic shock can increase the effective circulating blood volume and improve the perfusion of tissue and organ, which not only raise the cure rate, but also decrease the mortality. The curative effect of 7.5% hypertonie saline fluid resuscitation methods is better than the method of the conventional resuscitation.