创伤失血性休克出血有效控制前限制性液体复苏的临床探讨

Clinical Discussion of Limited Fluid Resuscitation on Hemorrhagic Traumatic Shock without Controlling Bleeding

目的观察探讨限制性液体复苏救治出血有效控制前的创伤性失血性休克的临床效果。方法选取我院2010年7月至2012年5月126例创伤失血性休克的患者,随机分为A组(限制性液体复苏)和B组(充分性液体复苏)各63例,观察比较两组输液量、平均动脉压、死亡率及实验室指标(PLT、PT、APTT、Hg、BE等),进行统计学分析。结果两组复苏后的血气碱剩余值(BE)、血清乳酸值、血气指标与复苏前比较存在明显差异(P<0.05),A组改善程度更为显著(P<0.05),具有统计学意义。A组术后24h的ARDS、MODS、死亡率明显低于B组(P<0.05),具有统计学意义。结论限制性液体复苏救治出血有效控制前的创伤性失血性休克的临床效果显著,优于充分性液体复苏。

Objective To explore the clinical effect of limited fluid resuscitation on hemorrhagic traumatic shock without controlling bleeding. Methods 126 patients with traumatic hemorrhagic shock in our hospital from July 2012 to May 2010 were randomly divided into group A （limited fluid resuscitation） and group B （adequate fluid resuscitation） with 63 cases in each group. The infusion volume, mean arterial pressure, mortality and laboratory indexes （PLT, PT, APTT, Hg, BE） were compared between the two groups and analyzed statistically. Results There were statistical differences in the blood gas base excess （BE）, serum lactic acid content and blood gas indexes after resuscitation in two group compared with those before the resuscitation （P 〈0.05）, and the improve degree in the group A （limited fluid resuscitation） was more significant than group B （adequate fluid resuscitation） with statistical significance （P 〈0.05）. The ARDS, MODS, mortality after 24 hours in group A were significantly lower than those in group B with statistical significance （P 〈0.05）. Conclusions The clinical effect of limited fluid resuscitation on hemorrhagic traumatic shock without controlling bleeding is significant, and better than the adequate fluid resuscitation.