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碳酸氢钠林格氏液在失血性休克患者液体复苏中的临床研究。

Clinical study of sodium bicarbonated Ringer's solution on fluid resuscitation of patients with hemorrhagic shock.

机构信息

Emergency Medical Center, Wuwei People's Hospital, Gansu, China.

出版信息

Eur Rev Med Pharmacol Sci. 2022 Mar;26(5):1535-1542. doi: 10.26355/eurrev_202203_28218.

Abstract

OBJECTIVE

Fluid resuscitation is a crucial step in shock treatment, but the choice of crystal solution remains controversial. Sodium bicarbonated Ringer's solution can not only effectively expand blood volume, but also reduce tissue damage and acidosis. The study aims to evaluate the resuscitation effect of sodium bicarbonated Ringer's solution on patients with hemorrhagic shock.

PATIENTS AND METHODS

A total of 96 patients with hemorrhagic shock were randomly assigned to receive either normal saline solution (control group) or sodium bicarbonated Ringer's solution (experimental group). The changes in blood lactate, heart rate, arterial pH and mean arterial pressure (MAP) were measured at different time points. The 28-day survival rate, the incidence of complications, and the average length of hospital stay were recorded. Simult RESULTS: The heart rate, blood lactate, sodium, and chloride in the experimental group were significantly lower than those in the control group, while the MAP, potential of hydrogen (pH), bicarbonate, and base excess in the experimental group were significantly higher than those in the control group at every observed time point after resuscitation (p<0.05). Compared with the control group, the experimental group had a lower incidence of acute respiratory distress syndrome (ARDS) (8.3% vs. 22.9%, p<0.05), shorter mechanical ventilation time (2.2 vs. 3.5, p<0.05), and shorter intensive care unit length of stay (3.8 vs. 4.1, p<0.05). The 28-day survival rate between the two groups showed no significant differences (p>0.05).

CONCLUSIONS

Early resuscitation with sodium bicarbonated Ringer's solution could better maintain acid-base balance and hemodynamic stability and reduce the risk of related complications.

摘要

目的

液体复苏是休克治疗的关键步骤,但晶体溶液的选择仍存在争议。碳酸氢钠林格氏液不仅能有效扩充血容量,还能减轻组织损伤和酸中毒。本研究旨在评估碳酸氢钠林格氏液对失血性休克患者的复苏效果。

患者和方法

共 96 例失血性休克患者被随机分为生理盐水组(对照组)和碳酸氢钠林格氏液组(实验组)。分别在不同时间点测量血乳酸、心率、动脉 pH 值和平均动脉压(MAP)的变化。记录 28 天生存率、并发症发生率和平均住院时间。

结果

实验组心率、血乳酸、钠和氯均显著低于对照组,复苏后各观察时间点 MAP、氢离子浓度(pH)、碳酸氢盐和碱剩余均显著高于对照组(p<0.05)。与对照组相比,实验组急性呼吸窘迫综合征(ARDS)发生率较低(8.3% vs. 22.9%,p<0.05),机械通气时间较短(2.2 天 vs. 3.5 天,p<0.05),重症监护病房住院时间较短(3.8 天 vs. 4.1 天,p<0.05)。两组 28 天生存率无显著差异(p>0.05)。

结论

早期使用碳酸氢钠林格氏液复苏能更好地维持酸碱平衡和血流动力学稳定,降低相关并发症风险。

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