参麦注射液与羟乙基淀粉联合晶体液治疗失血性休克的对比研究

摘要

目的：观察参麦注射液联合晶体液治疗失血性休克的临床效果。方法：将80例失血性休克患者随机分为观察组、对照组各40例。所有患者均全身麻醉气管插管，在中心静脉压监测下进行林格氏液补充，并维持患者中心静脉压在5～12 mmHg(1 mmHg=0.133 kPa)之间，对照组以羟乙基淀粉500 mL静脉滴注，观察组以参麦注射液100 mL+400 mL生理盐水静脉滴注，比较2组治疗前后平均动脉压和心率变化情况，同时在患者手术结束时测量其血糖水平和乳酸水平，统计术中尿量。结果：治疗后2组平均动脉压均显著高于治疗前（P＜0.05），心率慢于治疗前（P＜0.05），且观察组平均动脉压高于对照组（P＜0.05），心率慢于对照组（P＜0.05）。观察组治疗后血糖、乳酸显著低于对照组（P＜0.05），尿量多于对照组（P＜0.05）。结论：对失血性休克患者使用参麦注射液联合晶体液进行复苏，能提高患者心功能，改善微循环，保护肾功能。%Objective: To investigate therapeutic efficacy of ShenMai injection combined with crystalloid solutions in treating hemorrhagic shock. Methods:Eighty patients were randomly divided into the observation group and the control group equally. All the patients accepted the infusion of Ringer's solution with regular checks on central venous pressure under general anesthesia by trachea cannula, and their central venous pressure was kept between 5 and 12 mmHg (1 mmHg=0.133 kPa), the control group received intravenous dripping of hydroxyethyl starch, 500 mL, the observation group intravenous dripping of ShenMai injection, 100mL, and physiological saline, 400mL, mean arterial pressure (MAP), the changes of heart rate of both groups were compared between before and after treating, the levels of blood glucose and lactic acid were detected by the end of the surgery, and urine volume was recorded. Results:MAP of both groups after treating was higher than that before treating (P<0.05), heart rate after treating was slower than that before treating (P<0.05), and the observation group was higher than the control group in MAP (P<0.05), heart rate of the observation group was slower than that of the control group (P<0.05). The observation group was lower than the control group significantly in the levels of blood glucose and lactic acid after treating (P<0.05), but more than the control group in urine volume (P<0.05). Conclusion:The patients with hemorrhagic shock return to consciousness with ShenMai injection and crystalloid solutions, which could protect renal function, improve heart function and microcirculation of the patients.