“类541液”治疗中重型霍乱128例体会

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doi：10.3969/j.issn.1007-614x.2014.15.20

摘 要 目的：探讨类541液治疗中重型霍乱的临床疗效。方法：1994-1995年收治霍乱患者128例，所有患者就诊时已出现轻重不一的脱水征、低血压和休克，故酌情开放2～4条静脉通路予快速静滴类541液。首日24小时补液量5 500～20 000ml，平均12 000ml。以后根据排便量及尿量调整补液量，同时应用环丙沙星、氧氟沙星或左氧氟沙星抗炎治疗，并根据血气分析、血清生化学检查适当补充钠、钾以及碳酸氢钠，5例患者加用低分子右旋糖酐，无应用多巴胺及间羟胺。结果：除1例因伴有冠心病转至上级医院治疗，余127例患者全部治愈出院。出院标准符合原卫生部卫生防疫司制定的诊断标准。住院5～8天，平均7天，无并发症发生。结论：类541液治疗中重型霍乱疗效显著，值得推广。

关键词 类541液 霍乱 补液量

Experience of “class 541 liquid” in the treatment of 128 cases of severe cholera

Wang Dejun

Department of Infectious Disease，the Central Hospital of Zhuanghe City，Liaoning 116400

Abstract Objective：To explore the clinical efficacy of class 541 liquid in the treatment of severe cholera.Methods：128 inpatients with cholera were selected from 1994 to 1995.All patients had different dehydration syndrome，hypotension and shock，so we opened 2～4 venous access to give rapid intravenous infusion of class 541 liquid.24 hour resus fluid of the first day was 5 500～20 000ml，and the average was 12 000ml.According the defecation quantity and urine volume to adjust resus fluid，at the same time，all patients were treated with ciprofloxacin，ofloxacin or levofloxacin anti-inflammatory treatment.Sodium，potassium and sodium bicarbonate were appropriately supplied according blood gas analysis and serum biochemical test.5 patients used low molecular dextran，without used dopamine and hydroxylamine.Results：1 case with coronary heart disease was sented to the superior hospital for treatment.Other 127 cases were all cured.Discharge standard conformed to the diagnosis standard that formulated by the health and epidemic prevention department of health department.The hospitalization day was 5 to 8 days.The average was 7 days.None had complications.Conclusion：Class 541 liquid in the treatment of severe cholera has a significant effect，so it is worth promoting.

Key words Class 541 liquid；Cholera；Resus fluid

霍乱（Cholera）是由01群或0139群霍乱弧菌引起的急性肠道传染病，具有发病急、传播快、涉及面广、危害严重等特点[1，2]。1994-1995年我地区霍乱暴发流行，我院传染科收治霍乱及疑似霍乱病例200余例，其中中重型霍乱患者128例，均应用“类541液”治疗。由于疑似霍乱病例及轻型病例静脉补液量少，未做观察、比较。现报告如下。

资料与方法

病例选择：1994-1995年收治霍乱患者128例，大部分有不洁海产品饮食史。其中男109例，女19例，年龄25～61岁，平均33岁。临床特点：中型57例（44.5%），重型71例（55.5%）。均有剧烈腹泻、呕吐，无腹痛及里急后重感，低血压、休克。有米泔水样便80例（62.5%），血水样便10例（7.8%），有腹直肌或腓肠肌痉挛67例（52.3%），声音嘶哑97例（75.8%），血压测不出18例（14.1%），心律失常3例（2.3%），急性肾功能不全5例（3.9%）。

诊断标准：按原卫生部卫生防疫司制定的诊断标准，经大便培养出小川型霍乱弧菌而确诊。

“类541液”制作方法：0.9%氯化钠注射液550ml+5%碳酸氢钠注射液40ml+10%氯化钾注射液5ml，5%葡萄糖注射液450ml+5%碳酸氢钠注射液40ml+10%氯化钾注射液5ml，用连通器或U型管连通。