允许性低压复苏策略结合多模式疼痛管理对创伤失血性休克患者血栓弹力图及外周血炎性因子水平的影响

Effects of permissive low-pressure resuscitation strategy combined with multimodal pain management on thromboelastogram and peripheral blood inflammatory factors levels in patients with traumatic hemorrhagic shock

目的探究允许性低压复苏策略结合多模式疼痛管理对创伤失血性休克患者血栓弹力图及外周血炎性因子水平的影响。方法选择2019年10月至2021年4月我院收治的86例创伤失血性休克患者作为研究对象,根据管理方案的不同将其分为对照组(43例,常规救治)和观察组(43例,允许性低压复苏策略+多模式疼痛管理+常规救治)。比较两组的救治效果。结果救治后,观察组的凝血反应时间(R)、凝血形成时间(K)短于对照组,凝血最终强度(MA)、凝固角高于对照组(P<0.05)。救治后,观察组的肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)水平低于对照组(P<0.05)。救治后,观察组的P物质(SP)、前列腺素E(PGE)、多巴胺(DA)水平低于对照组(P<0.05)。结论允许性低压复苏策略结合多模式疼痛管理可改善创伤失血性休克患者血栓弹力图及外周血炎性因子,抑制疼痛介质释放,值得推广。

Objective To explore the effects of permissive low-pressure resuscitation strategy combined with multimodal pain management on thromboelastogram and peripheral blood inflammatory factors levels in patients with traumatic hemorrhagic shock.Methods A total of 86 patients with traumatic hemorrhagic shock admitted in our hospital from October 2019 to April 2021 were selected as the research objects,and the patients were divided into control group(43 cases,conventional treatment)and observation group(43 cases,permissive low-pressure resuscitation strategy+multimodal pain management+conventional treatment)according to different management plans.The treatment effects of the two groups were compared.Results After treatment,the coagulation reaction time(R)and blood clot formation time(K)in the observation group were shorter than those in the control group,and the blood clot maximum intensity(MA)and solidification angle in the observation group were higher than those in the control group(P<0.05).After treatment,the levels of tumor necrosis factor-α(TNF-α)and interleukin-10(IL-10)in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of substance P(SP),prostaglandin E(PGE)and dopamine(DA)in the observation group were lower than those in the control group(P<0.05).Conclusion Permissive low-pressure resuscitation strategy combined with multimodal pain management can improve the thromboelastogram and peripheral blood inflammatory factors levels in patients with traumatic hemorrhagic shock,and inhibit the release of pain mediators,which is worthy of promotion.