控制性液体复苏治疗严重多发伤的疗效及其对血清炎症因子水平的影响

目的:观察控制性液体复苏治疗严重多发伤的疗效及其对降钙素原(PCT)、高敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)和白介素-6(IL-6)水平的影响。方法:选取2010年12月~2012年12月在我院就诊的多发伤患者64例,随机分为观察组和对照组,每组各32例,对照组予以快速液体复苏,观察组予以控制性液体复苏。观察和比较两组的复苏液体量、复苏1小时乳酸、复苏时间、确定手术时间、住院时间、治愈率和死亡率,以及入院时和治疗后患者的血清PCT、hs-CRP、IL-6和TNF-α水平。结果:治疗后,观察组的复苏液体量、复苏1h乳酸、复苏时间、确定手术时间、住院时间和死亡率较对照组明显降低或减少,而观察组的治愈率较对照组明显提高。两组治疗后血清PCT、hs-CRP、IL-6和TNF-α水平均较入院时明显降低(P0.01),且观察组以上指标的水平显著低于对照组(P0.01)。结论:控制性补液复苏对多发伤的疗效优于快速液体复苏,并可显著降低患者的血清PCT、hs-CRP、IL-6和TNF-α水平。

Clinical Efficacy of the Control Fluid Resuscitation on the Patients with Severe Multiple Injuries and its Effect in the Serum Inflammatory Cytokines Levels

Objective： To observe the clinical efficacy of control fluid resuscitation in the treatment of patients with serious multip- le injuries and its effect on the serum levels ofprocalcitonin （PCT）, tumor necrosis factor--α （TNF-α）, high-sensitive C-reactive protein （hs-CRP） as well as interleukin -6 （IL-6）. Methods： 64 patients with severe multiple injuries hospitalized from December 2010 to December 2012 were randomly divided into the observation group and control group, 32 cases in each group. The control group was given rapid fluid resuscitation, the observation group was performed with control liquid recovery. The amount of liquid for resuscitation, lactate levels of lh, recovery time, time of determined surgery, hospitalization time, cure rate and mortality were detected in two groups. The levels ofPCT, hs-CRP, IL-6 and TNF-α were observed on admission and after treatment in two groups. Results： After treatment, the amount of liquid for resuscitation, lactate levels of lh, recovery time, the time of determined surgery, hospitalization time and mortality were significantly lower in the observation group compared with the control group （P〈0.01）, the cure rate of observation group was significantly higher than that of the control group. After treatment, the levels of PCT, hs-CRP, IL-6 and TNF-α were significantly lower compared with admission （P〈0.01）, and the reduce levels of observation group were more significantly than those in the control group （P〈0.01）. Conclusion： The efficacy of control fluid resuscitation in the treatment of patients with multiple trauma was superior to the rapid fluid resuscitation, which significantly lower the serum levels ofPCT, hs-CRP, IL-6 and TNF-α.