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目的:探究限制性液体复苏对失血性休克复苏患者血浆肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)水平的影响,为临床治疗失血性休克选择液体复苏方式提供依据。方法:选择2010年1月~2015年6月期间,我院收治出血性休克患者63例为研究对象;采用随机数字法将其分为观察组(32例)和对照组(31例),观察组患者给予限制性液体复苏,对照组患者给予传统充分复苏;观察并比较两组患者治疗前后血浆TNF-α、IL-6水平的变化。结果:观察组患者给予复苏液体的输入量为(1.95±0.35)L,对照组患者给予输液量为(3.61±0.56)L,观察组患者给予的复苏液输入量显著低于对照组,差异具有统计学意义(P<0.05);治疗前两组患者血浆TNF-α及IL-6水平不存在显著差异(P>0.05);治疗后两组患者血浆TNF-α及IL-6水平均显著上升,且观察组患者血浆TNF-α及IL-6水平均显著低于对照组,差异具有统计学意义(P<0.05)。结论:限制性液体复苏能够明显降低失血性休克患者的出血量,稳定机体血流动力学,保证机体重要脏器的血流灌注,有利于改善患者血浆TNF-α和IL-6水平,提高治疗效果,改善预后。
Objective: To investigate the effect of restrictive fluid resuscitation on the levels of plasma tumor necrosis factor (TNF-α) and interleukin-6 (IL-6) in patients with hemorrhagic shock resuscitation, and to provide basis for selecting liquid resuscitation methods for hemorrhagic shock. Methods: From January 2010 to June 2015, 63 cases of hemorrhagic shock in our hospital were selected as the research object. The patients were divided into observation group (32 cases) and control group (31 cases) by random number method. Restrictive fluid resuscitation was given to patients in group A and patients in control group were given adequate traditional resuscitation. The changes of plasma TNF-α and IL-6 levels in both groups before and after treatment were observed and compared. Results: In the observation group, the input volume of resuscitation fluid was (1.95 ± 0.35) L, while that of the control group was (3.61 ± 0.56) L. The input volume of resuscitation fluid in the observation group was significantly lower than that of the control group (P <0.05). There was no significant difference in plasma TNF-α and IL-6 levels between the two groups before treatment (P> 0.05). After treatment, the levels of TNF-α and IL-6 in plasma increased significantly , And the levels of plasma TNF-α and IL-6 in the observation group were significantly lower than those in the control group, with statistical significance (P <0.05). CONCLUSIONS: Restrictive fluid resuscitation can significantly reduce the amount of bleeding in patients with hemorrhagic shock, stabilize the hemodynamics of the body and ensure the blood perfusion of vital organs in the body, which is beneficial to improve the level of plasma TNF-α and IL-6 and improve the treatment Effect, improve the prognosis.