限制性液体复苏对产科失血性休克患者血清中炎症介质及氧化应急水平的影响

Effect of limited fluid resuscitation on the serum levels of inflammatory mediators and oxidative stress in patients with obstetric hemorrhagic shock

目的探讨限制性液体复苏对产科失血性休克患者炎症因子和氧化应激水平的影响。方法选择2014年3月-2016年3月在本院治疗的产科失血性休克患者40例,随机将患者分为实验组和对照组,实验组采用限制性液体复苏,对照组患者常规复苏。比较2组患者治疗效果、复苏前后的炎症因子、氧化应激产物水平。结果实验组患者液体输入量、出血量、输血量均低于对照组,MODS、ARDS、ARF发病率均低于对照组,差异有统计学意义(P<0.05)。实验组复苏前后TNF-α、IL-1β、IL-6、IL-18、MDA、AOPP、GSH-PX和SOD水平差异均无统计学意义(P>0.05),对照组复苏后炎症因子、MDA和AOPP水平均高于复苏前,GSH-PX和SOD水平低于复苏前,差异均有统计学意义(P<0.05)。结论限制性液体复苏在产科失血性休克患者中运用有助于提高复苏效果,降低炎症反应和氧化应激水平。

Objective To investigate the effect of limited fluid resuscitation on the levels of inflammatory factors and oxidative stress in patients with obstetric hemorrhagic shock. Methods 40 cases of patients with obstetric hemorrhagic shock treated in our hospital during March,2014- March,2016 were divided into the experimental group and the control group. The experimental group was given a limited fluid resuscitation,and the control group was given routine resuscitation. The therapeutic effects of two groups were compared,and the levels of inflammatory factors and oxidative stress were compared before and after resuscitation. Results The amount of liquid input,blood loss,blood transfusion in the experimental group were lower than the control group,and the incidence rates of MODS,ARDS,ARF were lower than the control group,and the differences were statistically significant（ P 〈 0. 05）. There was no statistical significance on the differences in the levels of TNF- α,IL- 1,IL- 6,IL-18,MDA,AOPP,GSH- PX and SOD before and after the recovery in the experimental group（ P 〉 0. 05）. In the control group,the levels of inflammatory factors,MDA and AOPP after recovery were higher than before recovery,but the levels of GSH- PX and SOD were lower than that before recovery,and the differences were statistically significant（ P 〈 0. 05）. Conclusion The application of limited fluid resuscitation in patients with obstetric hemorrhagic shock can help to improve resuscitation and reduce the level of inflammatory reaction and oxidative stress.