高渗氯化钠对失血性休克患者血清NO及CD18水平的影响
|
摘要
目的:研究高渗氯化钠治疗失血性休克患者的效果及对血清NO、CD18水平的影响。方法:选取我院2015年8月到2016年12月收治的失血性休克患者106例,采用分层随机分组法将其分为对照组和观察组,每组各53例。对照组患者接受静脉滴注纳洛酮注射液治疗,观察组患者在此基础上给予静脉滴注高渗氯化钠溶液治疗。比较两组患者的液体复苏情况、并发症发生情况及死亡情况,同时比较治疗前后血清一氧化氮(NO)和CD18水平的变化。结果:治疗后,观察组的血红蛋白(Hb)浓度明显高于对照组(P<0.01),输血量、复苏时间及平均动脉压(MAP)、血清NO和CD18水平、并发症总发生率和死亡率均明显低于对照组(P<0.05)。结论:高渗氯化钠联合纳洛酮治疗失血性休克的临床疗效显著,能够明显提高液体复苏质量、治疗安全性并改善患者预后,可能与其显著降低血清NO和CD18水平有关。
Objective: To study the effect of hypertonic sodium chloride on the treatment of hemorrhagic shock and effect on serum levels of NO and CD18. Methods: 106 cases with hemorrhagic shock who were treated in our hospital from August 2015 to December 2016 were selected and randomly divided into the control group and observation group with 53 cases in each group. The patients in the control group were treated with intravenous infusion of naloxone,while the patients in the observation group were treated with intravenous infusion of hypertonic sodium chloride on the basis of the control group. Then the fluid resuscitation,the incidence of complications and mortality,and the serum levels of nitric oxide(NO) and CD18 in the two groups were observed and compared before and after the treatment. Results: The concentration of Hb in the observation group was significantly higher than that of the control group(P <0.01),while the amount of blood transfusion,recovery time and MAP were significantly lower than those of the control group(P < 0.01); After treatment,the serum levels of NO and CD18 in the observation group were significantly lower than those of the control group(P <0.01); The incidence of complications and mortality rate of the observation group were significantly lower than that of the control group(P <0.05). Conclusion: Hypertonic sodium chloride combined with naloxone in treatment of hemorrhagic shock has better clinical efficacy,which can significantly reduce the serum levels of NO and CD18,and decrease the incidence of complications and death,and it is worthy of clinical promotion.
Objective: To study the effect of hypertonic sodium chloride on the treatment of hemorrhagic shock and effect on serum levels of NO and CD18. Methods: 106 cases with hemorrhagic shock who were treated in our hospital from August 2015 to December 2016 were selected and randomly divided into the control group and observation group with 53 cases in each group. The patients in the control group were treated with intravenous infusion of naloxone,while the patients in the observation group were treated with intravenous infusion of hypertonic sodium chloride on the basis of the control group. Then the fluid resuscitation,the incidence of complications and mortality,and the serum levels of nitric oxide(NO) and CD18 in the two groups were observed and compared before and after the treatment. Results: The concentration of Hb in the observation group was significantly higher than that of the control group(P <0.01),while the amount of blood transfusion,recovery time and MAP were significantly lower than those of the control group(P < 0.01); After treatment,the serum levels of NO and CD18 in the observation group were significantly lower than those of the control group(P <0.01); The incidence of complications and mortality rate of the observation group were significantly lower than that of the control group(P <0.05). Conclusion: Hypertonic sodium chloride combined with naloxone in treatment of hemorrhagic shock has better clinical efficacy,which can significantly reduce the serum levels of NO and CD18,and decrease the incidence of complications and death,and it is worthy of clinical promotion.
引文
[1]张建新,杨亚勤,牛丽丹,等.高渗氯化钠联合纳洛酮对失血性休克患者的临床疗效及安全性分析[J].现代生物医学进展,2016,16(24):4779~4782.
[2]黄静.限制性液体复苏对产科失血性休克患者血清中炎症介质及氧化应急水平的影响[J].中国卫生检验杂志,2016,19(20):2947~2949.
[3]刘海,越剑秋,彭晓静,等.内毒素吸附剂对失血性休克大鼠NO,IL-6及IL-12水平的影响[J].川北医学院学报,2016,31(3):348~351.
[4]方秀梅,焦丽强,郑学君,等.限制性液体复苏对多发伤合并失血性休克患者血清肌酸激酶及其同工酶、肌钙蛋白T的影响[J].中国地方病防治杂志,2015,33(2):137~138.
[5]黄海东,沈裴庆,孙世琦.乌司他丁对外伤失血性休克的临床疗效及血清肿瘤坏死因子-α的影响[J].海南医学院学报,2014,20(8):1067~1070.
[6]邹青,尤连峰,李伟,等.血清可溶性CD40配体和IL-18水平与脑梗死的关系分析[J].海南医学院学报,2016,22(13):1361~1364.
[7]刘运平,曹妍,王慧娟,等.丁苯酞氯化钠联合依达拉奉治疗急性脑梗死患者对血清MDA水平和SOD活力的影响[J].河北医药,2015,15(23):3561~3563.
[8]路艳,王立维,李玲,等.羟乙基淀粉130/0.4电解质注射液对休克患者血清降钙素原与C反应蛋白及S100β蛋白水平的影响[J].中国临床药理学杂志,2017,33(17):1654~1656.
[2]黄静.限制性液体复苏对产科失血性休克患者血清中炎症介质及氧化应急水平的影响[J].中国卫生检验杂志,2016,19(20):2947~2949.
[3]刘海,越剑秋,彭晓静,等.内毒素吸附剂对失血性休克大鼠NO,IL-6及IL-12水平的影响[J].川北医学院学报,2016,31(3):348~351.
[4]方秀梅,焦丽强,郑学君,等.限制性液体复苏对多发伤合并失血性休克患者血清肌酸激酶及其同工酶、肌钙蛋白T的影响[J].中国地方病防治杂志,2015,33(2):137~138.
[5]黄海东,沈裴庆,孙世琦.乌司他丁对外伤失血性休克的临床疗效及血清肿瘤坏死因子-α的影响[J].海南医学院学报,2014,20(8):1067~1070.
[6]邹青,尤连峰,李伟,等.血清可溶性CD40配体和IL-18水平与脑梗死的关系分析[J].海南医学院学报,2016,22(13):1361~1364.
[7]刘运平,曹妍,王慧娟,等.丁苯酞氯化钠联合依达拉奉治疗急性脑梗死患者对血清MDA水平和SOD活力的影响[J].河北医药,2015,15(23):3561~3563.
[8]路艳,王立维,李玲,等.羟乙基淀粉130/0.4电解质注射液对休克患者血清降钙素原与C反应蛋白及S100β蛋白水平的影响[J].中国临床药理学杂志,2017,33(17):1654~1656.