高渗盐水补液治疗急性失血性休克患者炎性因子及电解质代谢的影响研究

摘要

Objective To explore the effect of inflammatory factor and electrolyte metabolism of hypertonic saline rehydration therapy for patients with acute hemorrhagic shock.Methods 62 cases patients with acute hemorrhagic shock were divided into observation group and control group,the observation group were given hypertonic saline rehydration therapy,the control group given isotonic saline rehydration therapy,then plasma was used to substitute for recovery or blood products. physiological indexes,finflammatory cytokines,electrolyte metabolism before and after rehydration were compared between two groups.Result Physiology indexes:30min,1h after rehydration,observation group systolic pressure, diastolic blood pressure and urine volume were significantly higher than that of control group,the heart rate was significantly lower than the control group,2h after rehydration,observation group systolic blood pressure was significantly higher than that of control group(P<0.05);for inflammatory factor:1h,2h after rehydration,tumor necrosis factor alpha(TNF-α),interleukin-6(IL-6)and interleukin-8(IL-8)of observation group of were significantly lower than the control group(P<0.05);Electrolyte indicators:30min,1h after rehydration,there were no statistically difference of K+,Na+,Ga2+ between two groups(P>0.05).Conclusions Hypertonic saline rehydration therapy can improve physiological status in patients with acute uncontrolled hemorrhagic shock,inhibiting inflammatory cytokines,and won't cause electrolyte disorders,clinical effect is better than that of isotonic saline.%目的：探讨高渗盐水补液治疗对急性失血性休克患者炎性因子及电解质代谢的影响。方法选择62例急性失血性休克患者为观察对象，采用随机数字表法分为观察组与对照组，每组各31例。观察组给予高渗盐水补液治疗，对照组给予等渗盐水补液治疗，再应用血浆代用品或血液制品进行复苏。比较两组患者补液前后生理指标、炎性因子、电解质水平的变化。结果生理状态指标：补液后30min、1h，观察组收缩压、舒张压、尿量明显高于对照组，心率明显低于对照组，补液后2h，观察组收缩压明显高于对照组（P<0.05）。炎性因子：补液后1h、2h，观察组肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）均明显低于对照组（P<0.05）；电解质指标：补液后30min、1h，两组K+、Na+、Ga2+比较，差异无统计学意义（P>0.05）。结论高渗盐水补液治疗可有效改善急性失血性休克患者生理状态，抑制炎性因子，且不会引起电解质紊乱，临床效果优于等渗盐水。