高渗氯化钠对急性失血性休克的抢救效果及对血清NO、CD18水平影响

Effects of hypertonic sodium chloride in patients with acute hemorrhagic shock and serum NO and CD18 levels

目的:研究高渗氯化钠对急性失血性休克患者的抢救效果及对血清NO、CD18水平影响。方法:选取我院2012年8月到2017年12月间收治的106例急性失血性休克,采用随机数字法将其分为对照组和观察组(n=53)。所有患者均接受急诊内科常规治疗,对照组在此基础上给予纳洛酮1.2mg与5.0%葡萄糖混合液治疗,5.0min·次-1,静脉滴注3次后加量至4.0mg;观察组在对照组基础上静脉滴注7.5%高渗氯化钠溶液300ml治疗,滴注时间控制在15.0～20.0min。比较两组患者的液体复苏情况、并发症发生率及死亡率,同时比较治疗前后的血清NO和CD18水平。结果:观察组血红蛋白浓度明显高于对照组(P<0.01),输血量、复苏时间及平均动脉压均明显低于对照组(P<0.01);治疗后,观察组的血清NO和CD18水平均明显低于对照组(P<0.01);观察组的总并发症发生率和死亡率均明显低于对照组(P<0.05)。结论:高渗氯化钠联合纳洛酮治疗失血性休克的临床疗效显著,能够明显提高液体复苏质量,同时降低血清NO和CD18水平,减少并发症及死亡的发生,治疗安全性可靠,值得在临床推广。

Objective:To investigate the effects of hypertonic sodium chloride in patients with acute hemorrhagic shock and their serum nitric oxide(NO)andCD18 level.Methods:All together106 patients with acute hemorrhagic shock admitted to our hospital from August 2012 to December 2017 were enrolled and randomly divided into the control group and the observation group with 53 patients in each group.All of the patients received routine emergency medical treatment.The control group was treated with naloxone 1.2 mg and 5.0%glucose mixture,5.0 min·times^-1,intravenous drip 3 times and then dosage 4.0 mg.The observation group was treated with an intravenous drip of 7.5%hypertonic sodium chloride solution 300 ml on the basis of the control group,and the drip time was controlled between 15.0 min and 20.0 min.The fluid resuscitation,the incidence rate of complication and mortality,and the serum NO and CD18 levels of the two groups before and after treatment were compared.Results:The concentration of Hb in the observation group was significantly higher than the control group(P<0.01).The amount of blood transfusion,recovery time and MAP were significantly lower than the control group(P<0.01).After treatment,the observation group of serum NO and CD18 levels of the observation group was significantly lower than the control group(P<0.01).The total complication incidence and mortality of the observation group were significantly lower than the control group(P<0.05).Conclusion:Hypertonic sodium chloride combined with naloxone can significantly improve the quality and decrease the levels of NO and CD18 level,and reduce the occurrence of complications and death.