联合参附注射液治疗老年高钠性高渗性脱水的临床研究

摘要

目的：研究联合参附注射液治疗老年高钠性高渗性脱水患者的疗效。方法选取2013年1月至2016年1月本院重症监护室符合标准的老年高钠性高渗性脱水患者60例，随机分为对照组30例，予常规补液治疗；治疗组30例，予常规补液联合参附注射液治疗，分析比较治疗前后患者生命体征及相关指标的变化，并计算渗透压水平与治疗1周死亡率。结果60例患者治疗72小时后心率、呼吸频率有下降，收缩压较治疗前有升高；血气分析氧分压较治疗前上升；APACHE Ⅱ评分、血钠水平、渗透压水平较治疗前下降；血白蛋白水平较治疗前升高，P值均小于0.05，差异有显著性。治疗组治疗后心率、APACHE Ⅱ评分较对照组低，收缩压及血气分析氧分压较对照组高，P值均小于0.05，差异有显著性。治疗组治疗1周后死亡9例，死亡率为30%，对照组治疗1周死亡17例，死亡率为56.7%，差异有显著性（P＜0.05）。结论老年高钠性高渗性脱水患者病情危重，治疗复杂，病死率高，合理有效的补液联合参附注射液治疗，临床疗效肯定。%Objective To observe the curative effect of Shenfu injection in the treatment of elderly patients with high sodium hypertonic dehydration. Method From January 2013 to January 2016, 60 cases of elderly patients with hypernatronemia and hypertonic dehydration were selected, who were be hospitalized in the intensive care unit, they were randomly divided into 2 groups, control group 30 cases with conventional rehydration therapy; treatment group 30 cases with conventional rehydration therapy and Shenfu injection treatment, the change of vital signs and related indexes were compared after treatment, and the osmotic pressure level and the mortality were calculated after 1 week treatment. Result 60 cases of elderly patients after treatment for 72 hours, there is a decrease in the heart rate, breathing rate, APACHE Ⅱ score, serum of sodium level and osmotic pressure level; there is an increase in the systolic blood pressure, the blood gas analysis oxygen partial pressure and the serum level of the albumin, P were values less than 0.05, there are significant difference between two groups. After treatment, the heart rate, APACHE Ⅱ score in the treatment group was lower than that in the control group; the systolic blood pressure and blood gas analysis of oxygen partial pressure in the treatment group was higher than that in the control group, P were values less than 0.05, there are significant difference between two groups. One week after treatment, 9 patients died in the treatment group, the mortality was 30%; 17 patients died the in control group, the mortality was 56.7%, there are significant difference between two groups (P<0.05). Conclusion The elderly patient with hypernatronemia and hypertonic dehydration is in a critical condition, the treatment is complicated, the mortality is high, the treatment of reasonable and effective rehydration and combined with Shenfu injection, the clinical curative effect is affirmation.