羟乙基淀粉130／0．4氯化钠注射液在早期失血性休克院前急救中的临床应用体会

Clinical application of hydroxyethyl starch 130/0.4 and sodium chloride injection in patients withearly hemorrhagic shock pre-hospital emergency

目的探讨羟乙基淀粉130／0．4氯化钠注射液复苏方法对早期失血性休克的临床疗效。方法将52例早期失血性休克患者按随机数字表法分为复方氯化钠注射液组（对照组）和羟乙基淀粉130／0．4氯化钠注射液组（治疗组），每组26例，观察比较两组患者治疗效果，治疗前和治疗后60min的平均动脉压、呼吸频率和心率以及血钠、血氯和凝血酶原时间。结果治疗组和对照组治愈率分别为84．6％（22／26）和38．5％（10／26），病死率分别为15．4％（4／26）和61．5％（16／26），两组比较差异均有统计学意义（P〈0．05）。治疗组治疗后60min平均动脉压、心率和呼吸频率均较对照组明显改善[（91．5±8．6）mmHg（1mmHg=0．133kpa）比（78．5±7．9）mmHg、（81．5±8．6）次／min比（108．4±10．2）次／min、（21．4±5．3）次／min比（25．5±4．6）次／min，P〈O．05]；两组治疗前与治疗后60min血钠、血氯、凝血酶原时间比较差异无统计学意义（P〉0．05）。结论采用羟乙基淀粉130／0．4氯化钠注射液复苏方法治疗早期失血性休克可增加有效循环血量，改善组织器官灌注，降低病死率。

Objective To investigate the clinical efficacy of hydroxyethyl starch 130/0.4 and sodium chloride injection in the treatment of patients with early hemorrhagic shock （HS）. Methods Fifty-two cases of early HS were divided into compound sodium chloride injection group （control group,26 cases） and hydroxyethyl starch 130/0.4 sodium chloride injection group （treatment group,26 cases） by random digits table. The clinical effect, mean arterial pressure （MAP）, respiratory rate （RR） and heart rate （HR） and serum sodium,serum chloride and prothrombin time （PT） were statistically analyzed before and after treatment for 60 min. Results Cure rates in treatment group and control group were 84.6%（22/26） and 38.5% （10/26）,and mortality rates were 15.4% （4/26） and 61.5% （16/26）,respectively. The difference showed statistical significant （P 〈 0.05 ）. MAP, HR and RR in treatment group were obviously improved compared with control group[ （91.5 ± 8.6） mm Hg（ 1 mm Hg = 0.133 kPa） vs. （78.5 ± 7.9） mm Hg, （81.5 ± 8.6） times/min vs. （ 108.4 ± 10.2 ） times/min, （21.4 ± 5.3 ） times/min vs. （25.5 ± 4.6） times/min,P 〈 0.05 ]. Compared with control group, serum sodium, serum chloride and PT in treatment group were no significant difference （P 〉 0.05）. Conclusion Hydroxyethyl starch 130/0.4 and sodium chloride injection could increase the effective circulating blood volume, and improve tissue and organ perfusion and reduce mortality during the patients with early HS.