Objective To study the effect of hypertonic sodium chloride in the treatment of patients with traumatic hemorrhagic shock and the effects of NO and neutrophil surface CD 18 on the serum.Methods 120 patients with traumatic hemorrhagic shock were admitted to the hospital from December 2013 to December 2016,and randomly divided into the observation group and the control group.The control group was given nal-oxone injection,while the observation group was given hypertonic Sodium Chloride Solution.The two groups were compared before and after treatment,hemoglobin concentration,total infusion,24 h mortality,recovery time and adverse reactions,and the patients′hemodynamic and NO and CD18 levels were measured on the ser-um.Results After 24 h treatment,the observation group total infusion was(1 203.13 ± 117.82)mL,the re-covery time was(60.73 ± 5.63)min,24 h mortality rate of 5.00% was significantly lower than the control group total infusion(1 672.38 ± 123.64)mL,the recovery time(71.82 ± 6.19)min,24 h death rate 16.67%, hemoglobin concentration(91.24 ± 5.71)g/L higher than that of the control group(79.45 ± 6.18)g/L,the difference was statistically significant(P<0.05).Before treatment,there was no difference in the contents of NO and CD18 between the two groups.After treatment,two groups of patients with serum NO,CD18 content significantly decreased,but the observation group NO(20.27 ± 6.65)mol/L,CD18(41.67 ± 13.24)ng/mL were significantly lower than the control group NO(29.12 ± 8.23)mol/L,CD18(52.64 ± 13.51)ng/mL,the difference were statistically significant(P<0.05).Before treatment,two groups of patients with hemodynam-ic indexes of arterial and venous pressure,no difference in heart rate(P> 0.05);after treatment,the two groups of patients with arterial and venous pressure and heart rate were improved,but the change index of the observation group than in the control group was stable,the difference was statistically significant(P<0.05). The complication rate of the observation group was 10%(6/60),which was significantly lower than that of the control group(15/60),and the difference was statistically significant(P<0.05).Conclusion The infiltra-tion of sodium chloride intravenous infusion could significantly decreased CD 18 and NO levels in the serum of the patients,the patients with stable hemodynamics,reduced the incidence of complications,worthy of clinical reference.%目的 分析高渗氯化钠用于创伤性失血性休克患者的抢救效果及对血清一氧化氮(NO)、中性粒细胞表面CD18的影响.方法 选取2013年12月至2016年12月期间该院急诊科收治的120例创伤性失血休克患者为研究对象,随机分为观察组和对照组各60例.对照组给予纳洛酮注射液,观察组在此基础上给予高渗氯化钠溶液.对比两组患者治疗前、后血红蛋白浓度,输注总量、24 h致死率、复苏时间及不良反应,并测定患者的血流动力学及血清中NO及CD18含量.结果 治疗24 h后,观察组输液总量[(1203.13 ± 117.82) mL]、复苏时间[(60.73 ± 5.63)min]、24 h死亡率(5.00%)明显低于对照组输液总量[(1672.38 ± 123.64) mL]、复苏时间[(71.82 ± 6.19)min]、24 h死亡率(16.67%),血红蛋白浓度[(91.24 ± 5.71)g/L]高于对照组[(79.45 ± 6.18)g/L],差异均有统计学意义(P<0.05).治疗前,两组患者的NO、CD18含量无差别;治疗后,两组患者血清中NO、CD18含量明显下降,但观察组NO[(20.27 ± 6.65)μmol/L]、CD18[(41.67 ± 13.24)ng/mL]明显低于对照组NO[(29.12 ± 8.23)μmol/L]、CD18[(52.64 ± 13.51)ng/mL],差异有统计学意义(P<0.05).治疗前,两组患者血流动力学指标动、静脉压、心率比较,差异无统计学意义(P>0.05);治疗后,两组患者的动、静脉压、心率均有所改善,但观察组指标的变化较对照组平稳,差异有统计学意义(P<0.05).观察组并发症发生率[10.00%(6/60)]明显低于对照组[25.00%(15/60)],差异有统计学意义(P<0.05).结论 采用高渗氯化钠静脉滴注可明显降低患者血清中CD18、NO水平,使患者的血流动力学平稳增加,降低并发症的发生率,值得临床借鉴.
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