摘要
长久以来,液体治疗主要用于围手术期和各种创伤、出血、感染及休克等患者,容量复苏、维持水电解质平衡、纠正酸碱失衡及水电解质分布异常等均属于液体治疗的范畴〔1〕。晶体液与胶体液均可用于液体治疗,但由于大量输注人工胶体液时机体难以迅速将溶质成分完全代谢并清除,导致溶质在组织内沉积而引起器官损害,因此目前较少用于临床,而晶体液由于其较好的安全性和经济性在临床中被广泛应用〔2〕。目前常用的晶体液包括非平衡盐溶液(生理盐水等)和平衡盐溶液(乳酸林格液及醋酸林格液),其中生理盐水(0.9%NaCl溶液)早在1832年便开始被用于流行性霍乱患者的液体治疗,但由于其仅含有高浓度的氯和钠,缺乏镁、钙等血浆中重要的电解质,因此大量输注生理盐水后极易引起高氯性酸中毒和电解质代谢紊乱,并且还可能导致肾小球滤过率减少而引起肾损伤,而平衡盐溶液在电解质及渗透压方面与细胞外液(血浆)更为接近,因此在液体治疗中应优先考虑〔2-3〕,但它们也均有各自的不足之处,甚至会引起严重的不良后果。
Balanced salt solution,an important part of fluid therapy,is widely used in patients of sepsis,perioperative period and shock to maintain the hemodynamic stability and homeostasis for that its composition is close to extracellular fluid.As a new generation of balanced salt solution,bicarbonated Ringer’s solution is faster,more effective and safer than acetated Ringer's solution and lactated Ringer's solution in improving the disturbance of microcirculation,correcting metabolic acidosis and maintaining the balance of water and electrolyte,therefore,it has certain advantages in maintaining effective circulating blood volume and stable internal environment in patients of sepsis,perioperative period and shock.
出处
《临床急诊杂志》
CAS
2020年第11期927-932,共6页
Journal of Clinical Emergency
关键词
碳酸氢钠林格液
液体治疗
脓毒症
围手术期
休克
bicarbonated Ringer’s solution
fluid therapy
sepsis
perioperative period
shock
