晶体液复苏在感染性休克中的研究进展

Advance in resuscitation of septic shock with crystalloid

液体复苏是感染性休克重要的治疗措施。最新指南推荐晶体液为感染性休克液体复苏的首选液体。然而,目前晶体液选择上仍存在争议。0.9%氯化钠溶液因含有过高浓度的氯离子可导致患者内环境紊乱及增加肾损伤;平衡盐液在液体复苏方面有重要作用,正受到重症医学界临床医师的重视。在肝肾功能不全和乳酸酸中毒患者中,醋酸林格液优于乳酸林格液。钠钾镁钙葡萄糖注射液适合于老年患者的治疗。

Fluid resuscitation is the mainstay therapy in septic shock.Crystalloid is recommended as the first choice for resuscitation in the latest Surviving Sepsis Campaign guidelines.However,there are still controversies about types of crystalloidin fluid resuscitation.Due to high concentration of chloride ion,normalsaline may cause acid-base disorderand kidney injury.Balanced salt solution seems to play a significant role in fluid resuscitation,which draws clinicians′interests.In patients with liver and kidney dysfunction and lactic acidosis,Ringer′s acetate solution is better than lactated Ringer′s solution.Sodium-potassium-magnesium-calcium-glucose solution may be suitable for old patients.