目的 探讨不同浓度的高渗盐水在急性失血性休克早期液体复苏中的应用效果.方法 80例急性失血性休克患者根据复苏方法分为治疗组与对照组,各40例,手术治疗后都采用早期液体复苏,其中对照组采用3.0％氯化钠+6％羟乙基淀粉组作为高渗盐水,治疗组采用4.5％氯化钠+6％羟乙基淀粉组作为高渗盐水.观察比较两组治疗前后血浆白细胞介素与血钾、钠的变化.结果 两组患者急诊治疗后均痊愈出院,但与对照组相比,治疗组在液体复苏后1h的血浆白细胞介素(IL)1、IL-6和IL-8都明显降低(P＜0.01).两组在休克复苏前后的血钾比较,差异无统计学意义,而血钠在液体复苏后1h后,对照组有明显上升(P＜0.05),治疗组变化不明显.结论 高渗盐水在急性失血性休克早期液体复苏中的应用可有效抑制炎性因子,且机体电解质无明显不利变化,值得推广应用.%Objective To investigate the application effect of different concentrations of hypertonic saline for early liquid resuscitation in acute hemorrhagic shock patients. Methods 80 cases of acute hemorrhagic shock were equally divided into the treatment group and the control group according to the resuscitation method ,40 cases each. All cases were given early liquid resuscitation after surgery, the control group were given the 3.0% sodium chloride + 6% hydroxyethyl starch as the hypertonic saline,and the treatment group were given the 4. 5% sodium chloride + 6% hydroxyethyl starch as the hypertonic saline. The plasma interleukin and serum potassium, sodium changes of the two groups were observed and compared before and after treatment. Results All patients were discharged from hospital after emergency treatment, compared to the control group, the plasma IL-1, IL-6 and 1L-8 of the treatment group 1 hour after resuscitation were significantly lower( P ＜ 0.01) . Serum potassium of the two groups had no significant difference before and after re-suscitatio, but the serum sodium of the control group were increased significantly 1 hour after resuscitation (P ＜0.05),while no obvious change was observed in the treatment group. Conclusion Application of hypertonic saline for early liquid resuscitation in hemorrhagic shock patients can effectively inhibit inflammatory cytokines,and there is no significant adverse changes in body electrolyte,thus is worth of promotion.
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