Abstract：Objective To investigate the effect of Ringer Acetate Solution of balanced resuscitation fluid on the clinical indicators of hemorrhagic shock patients,and to provide reference for the efficacy and safety of balanced resuscitation fluid in the treatment of hemorrhagic shock.Methods A total of 124 patients with traumatic hemorrhagic shock who underwent emergency surgery in Dongguan Huangjiang Hospital from April 2019 to December 2019 were selected as the research objects.The patients were divided into the observation group and the control group according to the random number table method,with 62 cases in each group.Patients in the observation group were given Ringer Acetate Solution,while those in the control group were given normal saline.Advanced pre-hospital first aid treatment,surgical treatment,salinger by injection of acetic acid liquid and physiological saline respectively for fluid resuscitation to correct shock,blood was collected before and after operation to detect D-dimer,blood calcitonin original part,thrombin time (TT) and activated clotting time (APTT),prothrombin time (PT),live enzymes among the ion concentration of electrolyte,arterial blood acid-base balance,and surgery clinical indicators of two groups were recorded.Results D-dimer,serum procalcitonin and lactic acid (LAC) in the observation group at 2 hours after surgery were lower than those in the control group,the differences were statistically significant(P＜0.05).The APTT and PT of the observation group at 2 hours after surgery were shorter than those of the control group,the differences were statistically significant (P＜0.05).The actual base excess (BE) and pH values in the observation group at 2 hours after surgery were higher than those in the control group,the differences were statistically significant (P＜0.05).There were no differences between the two groups in operation time,anesthesia time,anesthesia recovery time,intraoperative blood loss,urine volume and electrolyte level(P＞0.05).Conclusion Ringer Acetate Solution of balanced resuscitation fluid can reduce the expression of D-dimer and blood procalcitonin in patients with hemorrhagic shock,reduce blood lactic acid and improve microcirculation,which is worthy of clinical application.
钱进;丁志文;叶绿青;李锋华. 醋酸林格液在失血性休克患者中的应用[J]. 中国当代医药, 2021, 28(5): 53-57.
QIAN Jin DING Zhi-wen YE Lv-qing LI Feng-hua. Application of Ringer Acetate Solution in patients with hemorrhagic shock. 中国当代医药, 2021, 28(5): 53-57.
Forte DM，Martin MJ.Response to the letter to the editor regarding：Titrate to equilibrate and not exsanguinate! Characterization and validation of a novel partial resuscitative endovascular balloon occlusion of the aorta catheter in normal and hemorrhagic shock conditions[J].J Trauma Acute Care Surg，2020，88（2）：e108-e109.
[5]
低血容量休克复苏指南（2007）[J].中国实用外科杂志，2007，27（8）：581-587.
[10]
Tong YM，Dong YY，Feng Y，et al.Methane-Rich Saline：A Potential Resuscitation Fluid for Hemorrhagic Shock[J].Oxid Med Cell Longev，2019，2019：4929107.
Devorah W，Rachel M，Deirdre K.Procalcitonin and Bacterial Sepsis in Burn Patients in South Africa[J].J Surg Res，2020，246：490-498.
[2]
Chu C，Yang C，Wang X，et al.Early intravenous administration of tranexamic acid ameliorates intestinal barrier injury induced by neutrophil extracellular traps in a rat model of trauma/hemorrhagic shock[J].Surgery，2020，167（2）：340-351.
[3]
Wilfred BS，Madathil SK Cardiff K，et al.Alterations in Peripheral Organs following Combined Hypoxemia and Hemorrhagic Shock in a Rat Model of Penetrating Ballistic-Like Brain Injury[J].J Neurotrauma，2020，37（4）：656-664.
[4]
Pfortmueller CA，Faeh L，Müller M，et al.Fluid management in patients undergoing cardiac surgery：effects of an acetate-versus lactate-buffered balanced infusion solution on hemodynamic stability（HEMACETAT）[J].Crit Care，2019，23（1）：159.
[6]
Duan C，Li T，Liu L.Efficacy of limited fluid resuscitation in patients with hemorrhagic shock：a meta-analysis[J].Int J Clin Exp Med，2015，8（7）：11 645-11 656.
[7]
Judith K，Bjoern H，Sven L，et al.Comparison of Malated Ringer′s with Two Other Balanced Crystalloid Solutions in Resuscitation of Both Severe and Moderate Hemorrhagic Shock in Rats[J].Biomed Res Int，2015，2015：151503.
[8]
Lin KH，Liu CL，Kuo WW，et al.Early Fluid Resuscitation by Lactated Ringer′s Solution Alleviate the Cardiac Apoptosis in Rats with Trauma-Hemorrhagic Shock[J].PLoS One，2016，11（10）：e0165406.
[9]
Nassoiy SP，Byron KL，Majetschak M.Kv7 voltage-activated potassium channel inhibitors reduce fluid resuscitation requirements after hemorrhagic shock in rats[J].J Biomed Sci，2017，24（1）：8.
[11]
Yao F，Lu YQ，Jiang JK.Immune recovery after fluid resuscitation in rats with severe hemorrhagic shock[J].J Zhejiang Univ Sci B，2017，5（18）：402-409.
[12]
Xu ZP，Song Q，Qiu ZL，et al.Research Article The effect of acetate Ringer′s solution on inflammatory factors and NF-κB signal pathway in the liver of hemorrhagic shock rats[J].Genet Mol Res，2018，17：2.
[14]
Matthew JD，Sandro BR，Shawn GR，et al.Prehospital Resuscitation of Traumatic Hemorrhagic Shock with Hypertonic Solutions Worsens Hypocoagulation and Hyperfibrinolysis[J].Shock，2015，44（1）：25-31.
[15]
Serkan D，Mehmet E，Salih MB，et al.Comparison of warm fluid and cold fluid resuscitation during uncontrolled hemorrhagic shock model in rats[J].Ulus Travma Acil Cerrahi Derg，2017，23（4）：287-293.
[17]
Pushpa S，Brandi B，John E K，et al.Effects of volume and composition of the resuscitative fluids in the treatment of hemorrhagic shock[J].J Emerg Trauma Shock，2012，5（4）：309-315.
[18]
Fujita Y，Nishimura M，Komori NW，et al.A pair of cell preservation solutions for therapy with human adipose tissue-derived mesenchymal stromal cells[J].Regen Ther，2020，14：95-102.
Zhou F，Peng ZY，Bishop JV，et al.Effects of fluid resuscitation with 0.9% saline versus a balanced electrolyte solution on acute kidney injury in a rat model of sepsis[J].Crit Care Med，2014，42（4）：e270-e278.
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