Objective To investigate dilatancy effect of the Hypertonic Sodium Chloride Hydroxythyl Starch 40 injection (HSH) for the treatment of hemorrhagic shock.Methods 70 cases with trauma induced hemorrhagic shock were randomly divided into two groups:Hypertonic Sodium Chloride Hydroxythyl Starch 40 injection group (H group), Ringer's group (R group), 35 cases in each group.Patients of H group were infused HSH10ml/kg within 30 minutes, the R group were infused Ringer's 10ml/kg at the same time.Central venous pressure (CVP), systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and oxygen saturation (SpO2) were monitored before the infusion, after the infusion and finished 30 minutes separately.Na+、Cl-、K+ were examined before infusion and after infusion respectively.Results The CVP、SBP、DBP、HR and SpO2 in both groups were improved than before infusion, but those in H group is much better than R group, with statistical significance (p<0.05).The potassium was reduced moderately and sodium ions and chloride ions were increased in H group than in R group, but it was still within normal range.Conclusion Appling HSH (10ml/kg) to patients with hemorrhagic shock can be better than the compound prescription of sodium lactate.

Objective To observe the clinical effect of artificial ventilation combined continuous positive airway pressure(CPAP) with removal of tracheobronchial foreign bodies for children and to explore the possibility and security of the method. Methods 60 children with tracheobronchial foreign body, underwent total intravenous anesthesia ,were randomly divided into A group and B group. Each group had 30 cases. A group was given artificial ventilation with CPAP. The bronchofibroscope was connected to anesthesia machine with side hole after induction for 3 minutes,and high fresh gas flow(10 ～ 15L/min) was given to maintain continuous positive airway pressure. B group were given high frequency jet ventilation(HFJV) ,60 ～ 100 bpm. The mask ventilation was given in stand of bronchofibroscope when SpO2 ＜ 90% and until SpO2 improved. MAP, HR, ECG, SpO2, PaO2, PaCO2 were monitored and recorded at time points: T0 (entered operation room), T1 (beginning of bronchofibroscopy), T2 (5 min after bronchofibroscopy), T3 (10 min after bronchofibroscopy), T4 (end of operation). The side effects, the rate of fail to bronchofibroscopy and the rate of intubations after operation in two groups were observed and recorded. Results The HR of post-anesthesia in two groups significantly decreased than those at T0 (P ＜ 0.01), but no difference showed in HR between two groups(P ＞ 0.05). SpO2 and PaO2 of post-anesthesia in two groups significantly increased than those at T0 (P ＜0. 01) ,PaO2 at T1 ,T2 ,T3 in A group were significantly higher than those in B group(P ＜0.05). PaCO2 gradually increased after bronchofibroscopy in two groups ,and the values in A group was significantly lower than in B group(P ＜0.05 or 0. 01). There were no significant differences in the rates of fail to bronchofibroscopy and of intubations after operation between two groups, but the total number of B group was higher. Conclusion Artificial ventilation with CPAP for children with removal of tracheobronchial foreign bodies was safe and practical, and has a better controllability, a minor effect to respiratory function, deserve popularizing.