【摘要】 目的探讨失血性休克患者早期大量应用羟乙基淀粉充分复苏对细菌移位的影响。方法将ICU收治的53例失血性休克患者分为两组,观察组给予6%羟乙基淀粉130/0.4大量快速充分复苏;对照组给予小剂量或不用6%羟乙基淀粉130/0.4,加平衡盐溶液、0.9%氯化钠溶液等治疗。两组复苏达标时间均不超过6 h。于患者入重症监护病房(ICU)和复苏6,12,24,48,72 h采外周静脉血进行血浆内毒素(LPS)浓度检测,患者入ICU室和复苏1,3,7 d行血细菌培养。比较两组患者细菌移位情况。结果两组同时间段细菌移位发生率及血浆内毒素含量均差异有极显著性(均P<0.01),两组外周血细菌培养总阳性率差异有极显著性(P<0.01)。结论早期大量应用羟乙基淀粉有利于失血性休克患者的液体复苏,能更好地减少细菌移位。更多还原

【Abstract】 Objective To study the effects of large doses of hydroxylethyl starch(Voluven) on bacterial translocation in patients with hemorrhagic shock at early stage in intensive care unit(ICU). Methods Fifty three patients received were randomly divided into two groups: given with 6% hydroxylethyl starch 130/0.4 to resuscitate quickly and completely as obvserved group and with less than or without 6% hydroxylethyl starch130/0.4 and 0.9% sodium chloride as control group,both groups resuscitated no less than 6 h.At the beginning of the resuscitation,blood from peripheral vein was taken out to detect changes of LPS(Plasm Lipopolysaccharide Endotoxin) at 0,6,12,24,48,72 h,and blood bacterial culture on 0,1,3,7 d,and bacterial translocation in two groups was compared. Results Significant difference was found in bacterial translocation and in plasma endotoxin level between two groups at the same period(P<0.01).Significant diference was also found in the total positive rate of blood bacterial culture between two groups(P<0.01). Conclusion Early application of high-dose Voluven in patients with hemorrhagic shock in ICU shows fewer bacterial translocation and lower LPS.更多还原