3.0%高渗盐水治疗四肢多发骨折低血容量性休克的效果

Effect of 3.0%hypertonic saline in treatment of hypovolemic shock caused by multiple fractures of limbs

目的探讨3.0%高渗盐水治疗四肢多发骨折所致低血容量性休克的效果。方法选取2019年2月~2020年1月我院收治的86例四肢多发骨折所致低血容量性休克患者作为研究对象,按照随机数字表法将其分为两组,每组各43例。对照组立即给予羟乙基淀粉130/0.4注射液和乳酸林格液,观察组则实施3%高渗盐水补充,比较两组患者治疗后的电解质水平、治疗过程中血浆渗透压及脑氧分压水平及术后12 h内简易精神状态量表(MMSE)评分。结果治疗后,观察组患者的钠离子、氯离子水平高于对照组,钾离子水平低于对照组,差异有统计学意义(P<0.05);治疗后30 min、2 h及12 h,观察组患者的血浆渗透压、脑氧分压均高于对照组,差异有统计学意义(P<0.05);治疗后12 h,观察组患者的MMSE评分高于对照组,差异有统计学意义(P<0.05)。结论针对四肢多发骨折所致低血容量性休克患者应用3.0%高渗盐水治疗,在一定程度上对维持血浆电解质平衡、提高血浆渗透压、确保脑氧供、提高神经功能有重要价值。

Objective To explore the effect of 3.0%hypertonic saline in treatment of hypovolemic shock caused by multiple fractures of limbs.Methods A total of 86 cases with hypovolemic shock caused by multiple fracture of limbs admitted in our hospital from February 2019 to January 2020 were selected as the research objects.They were divided into two groups according to the random number table method,with 43 cases in each group.The control group was given Hydroxyethyl Starch 130/0.4 Injection and Lactated Ringer′s solution immediately,the observation group was given 3%hypertonic saline supplement.The electrolyte levels,plasma osmotic pressure and cerebral oxygen partial pressure levels during the treatment,and the mini-mental state examination(MMSE)scores within 12 hours after operation were compared between the two groups.Results After treatment,the sodium ion and chloride ion levels in the observation group were higher than those in the control group,and the potassium ion level was lower than that in the control group,the differences were statistically significant(P<0.05);at 30 min,2 h and 12 h after treatment,the plasma osmotic pressure and cerebral oxygen partial pressure in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).At 12 h after treatment,the MMSE score in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).Conclusion To treat patients with hypovolemic shock caused by multiple fractures of limbs with 3.0%hypertonic saline is of great value to maintain plasma electrolyte balance,increase plasma osmotic pressure,ensure cerebral oxygen supply,improve nerve function to a certain extent.