参麦注射液在创伤性休克限制性液体复苏治疗中的应用观察(1)
【摘要】 目的：观察参麦注射液联合限制性液体复苏在创伤性休克中的临床治疗效果。方法：选取2013年6月-2014年5月在本院急诊、ICU住院的创伤性休克患者62例，按照随机数字表法将其分为试验组和对照组，每组31例。试验组患者在采用限制性液体复苏的基础上加用参麦注射液50 mL静滴，8 h后再使用一次；对照组患者只单纯采用常规限制性液体复苏治疗。观察两组患者不同时间的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)、尿量、血液流变学、升压药物用量等指标变化。结果：治疗后6、12 h，两组患者MAP、SpO2均较治疗前升高，尿量较治疗前均明显增加，且试验组的MAP、SpO2均明显高于对照组，尿量均明显多于对照组，差异均有统计学意义(P<0.05)。治疗后1、6、12 h，两组患者的HR较治疗前均明显下降，且试验组的HR均明显低于对照组，差异均有统计学意义(P<0.05)。试验组的全血黏度高切、全血黏度低切、血浆黏度、红细胞聚集指数等四项指标的下降程度均明显优于对照组，且治疗6 h后的去甲肾上腺素用量明显少于对照组，差异均有统计学意义(P<0.05)。结论：参麦注射液适合休克早期限制性液体复苏的联合治疗，能够改善创伤性休克的治疗效果，值得临床推广。
【关键词】 创伤性休克； 限制性液体复苏； 参麦注射液
【Abstract】 Objective：To observe the clinical therapeutic effect of Shenmai Injection combined with restrictive liquid recovery in the treatment of traumatic shock.Method：62 patients with traumatic shock in the emergency department and ICU of hospital from June 2013 to May 2014 were selected and randomly divided into the experimental group and the control group according to the random number table method，31 cases in each group.The experimental group was given restrictive liquid recovery combined with 50 mL Shenmai Injection for intravenously，used it again after 8 hours.The control group was only given routine restrictive liquid recovery for treatment.The index changes of mean arterial pressure(MAP)，heart rate(HR)，blood oxygen saturation(SpO2)，urine volume，blood rheology，booster drug dosage between the two groups at different times were observed.Result：At 6，12 h after treatment，the MAP，SpO2 of the two groups were significantly higher than before treatment，the urine volume were significantly more than before treatment，and the MAP，SpO2 of the experimental group were significantly higher than the control group，the urine volume were significantly more than the control group，the differences were statistically significant(P<0.05).At 1，6，12 h after treatment，the HR of the two groups were significantly lower than before treatment，and the HR of the observation group were significantly lower than the control group，the differences were statistically significant(P<0.05).The decrease degree of high shear and lower shear of blood viscosity，plasma viscosity and erythrocyte aggregation index in the experimental group were significantly better than the control group，and the Norepinephrine dosage in the experimental group 6 hours after treatment was significantly less than the control group，the differences were statistically significant(P<0.05).Conclusion：Shenmai Injection is suitable for the combination with early restrictive fluid recovery，can improve the therapeutic effect of traumatic shock，is worthy of clinical promotion., 百拇医药(郑奇志 罗会平 刘福松 张剑锋 谢湛荣)
【关键词】 创伤性休克； 限制性液体复苏； 参麦注射液
【Abstract】 Objective：To observe the clinical therapeutic effect of Shenmai Injection combined with restrictive liquid recovery in the treatment of traumatic shock.Method：62 patients with traumatic shock in the emergency department and ICU of hospital from June 2013 to May 2014 were selected and randomly divided into the experimental group and the control group according to the random number table method，31 cases in each group.The experimental group was given restrictive liquid recovery combined with 50 mL Shenmai Injection for intravenously，used it again after 8 hours.The control group was only given routine restrictive liquid recovery for treatment.The index changes of mean arterial pressure(MAP)，heart rate(HR)，blood oxygen saturation(SpO2)，urine volume，blood rheology，booster drug dosage between the two groups at different times were observed.Result：At 6，12 h after treatment，the MAP，SpO2 of the two groups were significantly higher than before treatment，the urine volume were significantly more than before treatment，and the MAP，SpO2 of the experimental group were significantly higher than the control group，the urine volume were significantly more than the control group，the differences were statistically significant(P<0.05).At 1，6，12 h after treatment，the HR of the two groups were significantly lower than before treatment，and the HR of the observation group were significantly lower than the control group，the differences were statistically significant(P<0.05).The decrease degree of high shear and lower shear of blood viscosity，plasma viscosity and erythrocyte aggregation index in the experimental group were significantly better than the control group，and the Norepinephrine dosage in the experimental group 6 hours after treatment was significantly less than the control group，the differences were statistically significant(P<0.05).Conclusion：Shenmai Injection is suitable for the combination with early restrictive fluid recovery，can improve the therapeutic effect of traumatic shock，is worthy of clinical promotion., 百拇医药(郑奇志 罗会平 刘福松 张剑锋 谢湛荣)