摘要
目的观察胰岛素对烧伤休克患者液体复苏的影响。方法选取烧伤休克期患者60例,随机分为对照组和治疗组,各30例。对照组予5%葡萄糖注射液联合维生素C静脉滴注治疗(每500 m L葡萄糖注射液+维生素C 1 g),治疗组予10%葡萄糖注射液1 000 m L+常规胰岛素20 U+10%氯化钾注射液30 m L+维生素C 2 g。治疗3 d。观察用药后第1个24 h实际补充量、胶体总量、第1个24 h尿量及休克期(烧伤后72 h内)总尿量,观察并记录两组患者休克期血常规中血小板计数,烧伤后2,3 d血清中总胆红素、尿素氮及肌酐含量变化。结果与对照组比较,治疗组第1个24 h单位胶体量及晶体量降低(P<0.01),第1个24 h尿量、休克期尿量及第4天单位尿量增加(P<0.01);治疗组血小板计数增加(P<0.05或P<0.01),与烧伤后1 d时比较,2 d及3 d时血小板计数明显减少(P<0.01),与2 d时比较,3 d时减低(P<0.01);治疗组2 d后血清总胆固醇、肌酐含量较对照组降低(P<0.01),3 d血清总胆红素、尿素氮及肌酐含量均降低(P<0.05,P<0.01);对照组烧伤后3 d血清总胆红素尿素氮及肌酐含量降低(P<0.01),治疗组烧伤后3 d上述指标均减少。结论烧伤休克期患者应用胰岛素,能明显减少复苏液体需求量,增加尿量,且对患者肝肾功能有潜在保护作用。
Objective To observe the influence of insulin on the resuscitation in burn Patients. Methods 60 Patients diagnosed as Burn Shock were selected and randomly divided into the treatment grouP and the control grouP,30 cases in each grouP. The control grouP were treated with 5% glucose injection combined with vitamin C （ with 1 g vitamin C in 500 mL glucose injection ）;the treatment grouP were treated with 10% glucose injection combined with insulin,10% KCl injection and vitamin C （ with 20 U insulin,30 mL KCl and 2 g vitamin C in 1 000 mL glucose injection ） . They were treated for 3 d. The actual infusion volume of colloid and crystalloid solution in the first 24 h after injury were recorded,and the urine outPut of the first 24 h and shock stage （ 72 h after injury ） were recored,the Platelet,TBil,urea nitrogen and creatinine were recored. Results ComPared with the control grouP,the actual infusion volume of colloid and crystalloid solution in the first 24 h in the treatment grouP were decreased （ P 〈 0. 01 ） ,the urine outPut of the first 24 h and shock stage （ 72 h after injury ） were increased （ P 〈 0. 01 ） ,the Platelet in the treatment grouP increased （ P 〈 0. 05,P 〈 0. 01 ） ,the Platelet at 2,3 d were decreased comPared with 1st day （ P 〈 0. 01 ） and were decreased at 3rd day comPared with 2nd day （ P 〈 0. 01 ）;the urea nitrogen and creatinine were decreased at 2nd day in the treatment grouP comPared with the control grouP（ P 〈 0. 01）,the TBIL, urea nitrogen and creatinine were decreased in the treatment grouP（ P 〈 0. 05,P 〈 0. 01） and were decreased at 3rd day（ P 〈 0. 01） . Conclusion Systemic aPPlication of insulin during burn resuscitation can reduce the fluid requirement,increase the urine outPut and Protect the organ function.
出处
《中国药业》
CAS
2015年第17期27-29,共3页
China Pharmaceuticals
