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目的研究高渗氯化钠羟乙基淀粉40注射液用于创伤病人手术的有效性和安全性。方法创伤评分(ISS)13～15分病人50例,随机分为高渗氯化钠羟乙基淀粉40组(H组)和林格组(R组),每组25例。两组病人均采用静吸复合麻醉,诱导时依次静注芬太尼2ug/kg、阿曲库铵0.5mg/kg、丙泊酚2mg/kg、气管插管后行机械控制呼吸,麻醉维持吸入1～2%异氟醚,微量泵持续灌注阿曲库铵0.25～0.5mg?kg-1?h-1、丙泊酚2.5～5 mg?kg-1?h-1.H组:术前输入高渗氯化钠羟已基淀粉40注射液250ml,输注速度10ml/h。R组:仅常规输入林格氏液。于给药前和停药后30min检测血气,观察并记录Na+Hct,观察并记录给药前、给药后5、10、15、20、25min和停药后30min的SBP、DBP、MAP、HR。术前放空尿袋,观察并记录停药后30min两组尿量。结果给药后5、10、15、20、25min和停药后30min,H组SBP、DBP、MAP均明显高于给药前(P<0.05),HR均低于给药前。H组给药后5、10、15、20、25min和停药后30min,SBP、DBP、MAP均高于R组(P<0.05),HR明显低于R组。停药后30min,H组Hct明显低于给药前(P<0.05)。H组Hct明显低于R组(P<0.05),H组尿量明显高于R组(P<0.05)。使用高渗氯化钠羟已基淀粉40注射液血压升高明显,未发现恶心、呕吐、皮肤潮红等不良反应。结论高渗氯化钠羟已基淀粉40注射液可以有效安全地用于创伤病人。
Objective To study the efficacy and safety of hypertonic sodium chloride hydroxyethyl starch 40 injection in traumatic patients. Methods Fifty patients (13 to 15) with trauma score (ISS) were randomly divided into 40 hypertensive group (H group) and Ringer group (25 group). Both groups of patients were treated with static inhalation anesthesia induction of fentanyl 2ug / kg, atracurium 0.5mg / kg, propofol 2mg / kg, intubation after mechanical control of breathing, anesthesia to maintain inhalation 1 ~ 2% isoflurane, continuous infusion of atracurium 0.25 ~ 0.5mg? Kg-1? H-1 and propofol 2.5 ~ 5 mg? Kg-1? H-1.H group Enter hypertonic sodium chloride hydroxy starch 40 injection 250ml, infusion rate 10ml / h. Group R: Ringer’s solution was routinely input. Blood gas was measured before administration and 30 minutes after drug withdrawal. Na + Hct was observed and recorded before treatment, SBP, DBP, MAP, HR. Urine bag was drained preoperatively, and the urine output of the two groups was observed and recorded after 30min withdrawal. Results SBP, DBP and MAP in group H were significantly higher than those before treatment (P <0.05) at 5, 10, 15, 20, and 25 min after drug administration and 30 min after drug administration, respectively. The levels of SBP, DBP and MAP in group H were significantly higher than those in group R (P <0.05) at 5, 10, 15, 20, and 25 min after drug administration and 30 min after drug withdrawal, and HR was significantly lower than that in R group. Hct was significantly lower in H group than that before administration (P <0.05) 30 min after stopping drug administration. The Hct of H group was significantly lower than that of R group (P <0.05). The urine output of H group was significantly higher than that of R group (P <0.05). The use of hypertonic sodium chloride Hydroxystarch 40 injection of blood pressure increased significantly, no nausea, vomiting, skin flushing and other adverse reactions. Conclusion Hypertonic sodium chloride hydroxyhexyl starch 40 injection can be effectively and safely used in trauma patients.