7.5%高渗盐水对择期腹部大手术后全身性炎症反应的影响

目的　探讨 7.5 %高渗盐水对择期腹部大手术后全身性炎症反应的影响。方法　连续 5 2例择期腹部大手术病人 ,配对分为两组对比。术毕进入SICU后 ,研究组 ( n=2 6)应用 7.5 %高渗盐水 ( 4ml/kg) ,后续平衡液 ;对照组 ( n =2 6)仅用平衡液。比较两组病人的液体平衡量、体重变化、PaO2 /FiO2 比值 ,以及并发症发生率和死亡率。结果　与对照组相比 ,研究组手术日和术后48h的液体正平衡量减少 (P <0 .0 0 1) ;术后体重增加幅度降低 (P <0 .0 0 1) ,体重下降时间提前 (P <0 .0 0 1) ;术后PaO2 /FiO2 比值较高 (P =0 .0 0 0 111) ;术后总体并发症发生率和肺部感染发生率较低 (P =0 .0 175 ,P =0 .0 3 74)。结论　 7.5 %高渗盐水可减少择期腹部大手术后的液体正平衡量 ,促进液体负平衡提前出现 ,有明显的抗炎作用

Effects of 7.5% hypertonic saline on systemic inflammation response after elective major abdominal surgery

Objective To investigate the effects of 7.5% hypertonic saline(HS) on systemic inflammation response after elective major abdominal surgery.Methods Fifty-two consecutive patients under-going elective major abdominal surgery were studied.The patients were assigned to receive either Ringer lactate solution following 4 ml/kg of HS(study group,n=26)or Ringer lactate solution (control group,n=26)during the early postoperative period in the surgical intensive care unit.We compared fluid balance,body weight change,PaO 2/FiO 2 values,the postoperative morbidity and mortality between the two groups.Results The volumes of positive fluid balance in operative day and during the first 48 hours following surgery were significantly lower among patients treated with HS than those in control group(P<0.000001).Body weight gain after surgery was significantly lesser in study group than in control group(P<0.000001).The postoperative PaO 2/FiO 2 values was significantly higher in study group than in control group(P<0.000001).Conclusion 7.5% HSucould reduce positive fluid balance,and accelerate negative fluid balance appearance more early after elective major abdominal surgery.7.5% HS had an significantly anti-inflammation effect.