醋酸钠林格注射液纠正失血性休克代谢性酸中毒的临床效果

医学研究与教育 ›› 2015, Vol. 32 ›› Issue (2): 50-53.

醋酸钠林格注射液纠正失血性休克代谢性酸中毒的临床效果

刘冬^1,2，曹志然¹，刘斌²

1. 河北大学基础医学院，河北保定 071000；2. 中国人民解放军第二五二医院麻醉科，河北保定 071000

出版日期:2015-04-25 发布日期:2015-04-25
通讯作者: 曹志然（1963—），女，河北景县人，教授，硕士生导师，主要从事免疫药理学研究。E-mail: caozhiran@163.com
作者简介:刘冬（1982—），女，河北保定人，主治医师，主要从事麻醉药理学研究。

Analysis of the clinical effect of acetate ringers in correcting metabolic acidosis in patients with hemorrhagic shock

LIU Dong^1,2, CAO Zhiran¹, LIU Bin²

1. College of Basic Medical Sciences of Hebei University, Baoding 071000, China; 2. Department of Anesthesiology, No. 252 Hospital of PLA, Baoding 071000, China

Online:2015-04-25 Published:2015-04-25

摘要/Abstract

摘要： 目的比较醋酸钠林格注射液与乳酸钠林格注射液对失血性休克患者代谢性酸中毒的影响。方法失血性休克患者 50 例，按随机数字表法分为醋酸钠林格注射液组（A 组）、乳酸钠林格注射液组（L 组），每组 25 例。观察诱导前（T₀），诱导后 1 h（T₁）、2 h（T₂）、3 h（T₃）、4 h（T₄）患者血液 pH 值、血乳酸值（LAC）、碱剩余（BE），HCO₃^-值及NaHCO₃用量。结果 2 组患者在 ASA 分级、手术时间、术中输入试验晶体液量、失血量这 5 项指标差异均无统计学意义（P>0.05）。A 组在 T₃ 时间点较 L 组 pH 值显著改善（P<0.05）；A 组 T₂时间点 LAC 值较 T₀ 点显著降低（P<0.05），L 组T₂、T₃、T₄ 时间点 LAC 值较 T₀ 点明显升高（P<0.05），且在 T₂、T₃、T₄时间点 LAC 值 L 组较 A 组显著升高（P<0.05）；NaHCO₃ 用量 A 组比 L 组减少（P<0.05）；BE 值两组间比较无显著差异。结论在失血性休克患者液体复苏过程中，醋酸钠林格注射液可使用更少 NaHCO₃ 用量、更快速改善血 pH 值，降低血乳酸水平。

关键词: 失血性休克, 醋酸钠林格注射液, 乳酸林格注射液, 血气

Abstract: Objective To compare the effects of acetate ringers solution and lactated ringers solution on metabolic acidosis in patients with hemorrhagic shock. Methods 50 patients with hemorrhagic shock were divided equally into 2 groups randomly(n=25): the acetate ringers solution(group A) and lactated ringers group(group L). Changes of arterial blood gas and volume of NaHCO₃ before and 1, 2, 3, 4h after induction respectively were observed. Results There were no statistics difference in the ASA grade, operation time, the volume of transfusion during operation and hemorrhage volume of both groups(P>0.05). pH in group A changed at time point of T3 respectively compared to group L(P<0.05). Serum lactate level(LAC) decreased at T₂ compared to T0 time in group A(P<0.05). LAC level increased at T₂, T₃, T₄ compared to T0 time in group L(P<0.05). LAC level in group L increased at time point of T₂, T₃, T₄ compared to group A(P<0.05). Volume of NaHCO₃ in group A decreased compared to group L (P<0.05). Conclusion Acetate ringers solution changes pH, decreases serum lactate level and decreases volume of NaHCO₃ during fluid resuscitation in hemorrhagic shock.

Key words: hemorrhagic shock, acetate ringers solution, lactated ringers solution, arterial blood gas

中图分类号:

R331

刘冬，曹志然，刘斌. 醋酸钠林格注射液纠正失血性休克代谢性酸中毒的临床效果[J]. 医学研究与教育, 2015, 32(2): 50-53.

LIU Dong, CAO Zhiran, LIU Bin. Analysis of the clinical effect of acetate ringers in correcting metabolic acidosis in patients with hemorrhagic shock[J]. Medical Reserch and Education, 2015, 32(2): 50-53.