晶体液和胶体液对液体复苏后腹内压升高影响的临床研究

Clinical Research of Intra-abdominal Pressure Changes after Fluid Resuscitation by Crystalloids or Colloids

目的观察研究感染性休克病人应用晶体液和胶体液进行液体复苏治疗对腹腔内压升高程度的不同影响。方法前瞻性选取感染性休克需液体复苏治疗病人40例,分为两组,其中晶体组20例应用乳酸林格氏液复苏,胶体组20例应用6%羟乙基淀粉(万汶)复苏,每组又按6 h内复苏液体量,细分为20 ml/kg以内组和20 ml/kg以上组。分别监测复苏前、复苏6 h后腹腔内压,比较腹内压力变化。结果应用晶体液液体复苏后,腹内压升高的程度与胶体液相比有统计学差异,尤其在20 ml/kg以上组差异更为显著。结论感染性休克病人液体复苏时,从对腹内压升高的影响来看,胶体液优于晶体液。

Objective To study the changes of intra-abdominal pressure after fluid resuscitation by Crystalloids or Colloids.Methods Prospectively selecting 40 cases of septic shock requiring the treatment of fluid resuscitation,and dividing them into two groups,in which crystal group using lactated Ringer′s solution and colloidal group using 6% Hydroxyethyl Starch 130/0.4 and Sodium Chloride Injection.Each group were divided into less than and more than 20 ml/kg groups.Monitoring the intra-abdominal pressure of 6 hours before and after,and compare the changes of intra-abdominal pressure.Results Application of crystal,intra-abdominal pressure increased with the extent of colloidal compared with statistically significant differences,especially in the more than 20 ml/kg group.Conclusion From the effects of elevated intra-abdominal pressure,colloid was superior to crystal on the fluid resuscitation of septic shock patients.