限制性液体复苏对创伤失血性休克患者的效果与急救护理

Effect of restrictive fluid resuscitation on trauma patients with uncontrolled hemorrhagic shock and first aid nursing

目的探讨限制性液体复苏对创伤失血性休克患者的效果与急救护理措施。方法将100例创伤失血性休克患者按数字表法随机分为对照组和观察组各50例，两组均采用急救护理程序进行急救，对照组采取常规液体复苏方法，观察组给予限制性液体复苏，比较两组患者抢救成功率、病死率、急性呼吸窘迫综合征（ARDS）发生率、多器官功能障碍综合征（MODS）发生率、复苏时间、患者家属对急救护理工作满意度。结果观察组患者抢救成功率、病死率、ARDS发生率、MODS发生率分别为80％，20％，4％，16％，对照组分别为60％，40％，28％，38％，两组比较差异有统计学意义（x2值分别为7．24，6．95，8．63，7．84；P〈0．01）；观察组复苏时间（95．67±25．03）min，对照组（200．18±35．12）min；观察组患者家属对急救护理工作满意度为（98．45±0．91）分，对照组为（91．12±4．07）分；两组复苏时间和满意度比较差异均有统计学意义（t值分别为5．23，4．59；P〈0．01）。结论创伤失血性休克患者应用限制性液体复苏，同时根据急救护理程序实施急救护理，可减少MODS和ARDS的发生，降低患者的病死率，提高抢救成功率和患者家属对急救护理工作的满意度。

Objective To discuss the effect of restrictive fluid resuscitation on trauma patients with uncontrolled hemorrhagic shock and first aid. Methods Totals of 100 patients with trauma patients with uncontrolled hemorrhagic shock randomly divided into control group and observation group with each group of fifty cases, and control group adopt conventional liquid recovery method, observation group was given restrictive fluid resuscitation. Observed and compared two groups of patients cure rate, mortality, and ARDS incidence, MODS incidence, recovery liquid quantity, recovery time, satisfaction of patients and families on first aid job. Results The incidence of patients＇ cure rate, mortality, ARDS, and MODS in observation group respectively were 80%, 20% , 4% , 8% and that in control group were 60% , 40%, 28%, 38% , and the difference was statistically significant （ X2=7.24,6.95,8.63,7.84, respectively ; P 〈 0.01 ）. Recovery time in observation group were significantly shorter than that in control group [ （ 95.67±25.03 ） vs （ 200.18 ± 35.12 ） mins ; t = 5.23, P 〈0.01 ], and the satisfaction of patients and families to first aid job in observation group was higher than that in control group [ （98.45±0.91 ） vs （91.12±4.07 ） ; t = 4.59, P 〈 0.01 ） ]. Conclusions Trauma patients with uncontrolled hemorrhagic shock application restrictive fluid resuscitation, and at the same time, according to the first aid program first aid care, can reduce the occurrence of MODS and ARDS patients, reduce the mortality and improve the cure rate and satisfaction of patients and families on first aid.