Effect Of Different Fluid Restriction Resuscitation On Inflammatory Factor In Patients With Trauma Hemorrhage Shock

Objective:To investigate the effects of different fluids(lactated Ringer's solution?acetated Ringer's solution)on resuscitation of peripheral blood inflammatory factors and arteriovenous blood gas in patients with traumatic hemorrhagic shock,and to provide a basis for screening relatively ideal resuscitation fluid.Methods: Forty patients with hemorrhagic shock admitted to the emergency department of the First Affiliated Hospital of Bengbu Medical College between January2016 and January 2019 were selected as subjects.All patients were randomly divided into experimental group and control group,20 cases each.The experimental group was treated with acetated Ringer's solution(AR)and the control group was treated with lactated Ringer's solution(LR),limited fluid resuscitation were used in both groups.Peripheral vein,arterial,and central venous blood samples were taken before starting resuscitation?30 minutes and 1 hour after resuscitation.Determination of serum IL-4?IL-6?TNF-???-IFN levels and serum lactate levels,arterial oxygen saturation,central venous oxygen saturation,arterial oxygen partial pressure,venous oxygen partial pressure.The inflammatory factors of peripheral blood and arteriovenous blood gas were compared between the two groups to observe the resuscitation effect of the two fluids.Results:After 30 minutes and 1 hour of resuscitation,the expression levels of inflammatory factors in peripheral blood of the two groups of shock patient is increased.There is no significant difference in the increase of IL-4 and ?-IFN between30 minutes after resuscitation and 1 hour after resuscitation(P>0.05),and the remaining differences have statistical significance(P<0.05).An independent sample t-test on thedifference in the magnitude of the increase can be found that compared with lactated Ringer's solution,acetated Ringer's solution resuscitated hemorrhagic shock patients can reduce the release of inflammatory factors IL-6 and TNF-? and the difference is statistically significant(P<0.05).However,there was no significant difference in the changes of IL-4 and ?-IFN(P>0.05).It shows that acetated Ringer's solution can reduce the level of inflammatory response in patients compared with lactated Ringer's solution.In the analysis of arteriovenous blood gas,the blood lactic acid decreased in the observation group 1 hour after resuscitation,while the blood lactic acid in the control group increased slightly,the difference was statistically significant(P<0.05).Artrial oxygen saturation,central venous oxygen saturation,arterial oxygen partial pressure,and venous oxygen partial pressure were improved in both groups,but there was no statistical difference(P>0.05).It shows that acetated Ringer's solution can correct acidosis in patients compared with lactated Ringer's solution.Conclusions: 1.In terms of inflammatory response,the application of sodium acetate Ringer's solution and lactate Ringer's solution can quickly restore effective circulating blood volume and maintain a certain blood pressure level,and can alleviate the level of inflammatory response in patients with hemorrhagic shock.However,sodium acetate Ringer's solution can further reduce the expression of TNF-? and IL-6 in patients with hemorrhagic shock,thereby reducing cell and tissue damage.2.In the analysis of arteriovenous blood gas,both fluids can improve arterial oxygen saturation,central venous oxygen saturation,arterial oxygen partial pressure and venous oxygen partial pressure in patients with hemorrhagic shock.However,the use of sodium acetate Ringer's solution to resuscitate the decline in arterial blood lactate value can better correct the acidosis in patients.