| Objective:The purpose of this paper is to through the observation of the changes of albumin?creatinine and blood lactate in hypovolemic shock patients, and evaluation of fluid resuscitation effect. Provide the basis for hypovolemic shock patients to a liquid and fluid resuscitation rescue disease outcomein clinical anesthesia.method:From March 2013 in the Second Affiliated Hospital of Kunming Medical University in November -2015 in hemorrhagic shock patients.1 select operation blood loss amount to 3000ml-4000ml and meet the inclusion criteria of a total of 18 cases. Albumin, general information (age, body weight, estimated blood volume, blood loss, bleeding volume/estimated blood volume) were collected.2 select operation blood loss amount to 3000ml-7000ml and meet the inclusion criteria of a total of 47 cases. The general data were collected (creatinine, age, weight, amount of bleeding, hydroxyethyl starch dosage). Collected preoperative serum creatinine, postoperative serum creatinine in the first day, on the second postoperative day, serum creatinine. Analysis hydroxyethyl starch damage of renal function.3 select the operation blood loss amount to 3000ml-3999ml and meet the inclusion criteria of the selected standard cases included in the A group, the blood loss of 7000-13000ml cases 13 cases included in the B group. Blood lactic acid, general information (age, body weight, gender, estimated blood volume) were collected, the first day of lactic acid value, second days after the operation, third days after the operation, lactic acid value was analyzed, and the changes of lactic acid value were analyzed. Statistical analysis was performed using SPSS IBM 17 software system.Result:1.18 cases of preoperative plasma albumin concentration was 40.6+3.0g/L, blood loss during the operation was 3300+250ml, the plasma albumin concentration was reduced to 25.1+6.6 g/L, the difference was statistically significant247 cases of cases, preoperative serum creatinine for 66.817.4+mol/L, renal SOFA score were 0; intraoperative blood loss 3931+1253ml. Hes lost fluence 2054+ 877ml. Postoperative first day of serum creatinine as 71.0+26.7 mol/L,2 cases of renal SOFA score= 1 case, occur rate was 4.3%,0 the rest of 45 cases of renal sofa score=. After surgery the next day serum creatinine for 69.1+21.9 mol/L, renal SOFA score= 1 case (2 cases), occurred rate was 4.3%, remaining 45 cases of renal SOFA score= 0; differences were not statistically significant.Is lower than the value of the lactic acid+after the first,+is lower than the value of the day after the first (+3285 3A group (n= 14), intraoperative bleeding volume 202ml p=0.269 operation of lactic acid value 4.0+2.4 mmol/L, after the second day of lactic acid value 2.6+1.9 mmol/L, after the third day of lactic acid value of 1.7+ 1.6 mmol/L, after the second and third day of lactic acid after the first day, the difference has statistical significance; group B (n= 13) intraoperative blood loss 9277 2264ml operation day lactic acid value of 4.2+2.8 mmol/L, after the second day of lactic acid value of 1.8+1.4 mmol/L, after the third day of lactic acid value of 0.8 0.3 mmol/L, with the second and third day after operation on the first day, the difference was statistically significant. A, B between the two groups were compared, the difference was not statistically significantConclusion:1 hemorrhagic shock patients with plasma albumin concentration decreased, colloid osmotic pressure decreased,130/0.4 HES capacity recovery does not affect renal function.2 lactic acid increased after hemorrhagic shock, with the improvement of tissue perfusion, third days after operation can be returned to normal. |
PDF Full Text Request