产科失血性休克液体复苏64例报告

Liquid Resuscitation on Obstetrical Hemorrhagic Shock: an Analysis of 64 Cases

目的:探讨产科失血性休克的液体复苏的策略。方法:通过对64例失血性休克患者的资料行回顾性分析,观察液体复苏的量和质,以及复苏时机与复苏效果的关系。结果:在休克早期1 h内快速输入平衡液1 500 ml,及时适量补充全血、血浆、凝血物质。使血色素维持在10 g、血球压积在30％者均为抢救成功。而未能及时有效补足血容量者则并发多脏器功能衰竭死亡。结论:失血性休克液体复苏的原则应是及时、迅速、有效补足血容量。本着先快后慢、先晶后胶、先盐后糖的原则。保证重要脏器血供、氧供是抢救成功的关键。

To investigate the liquid resuscitation in approach to treatment of the obstetrical hemorrhagic shock. Methods: By a retrospective analysis of 64 cases of obstetrical hemorrhagic shock, to examine what, how much and when to transfuse and their results. Results: The patients were saved on condition that 1 500 ml buffered solution was transfused within one hour immediately after shock happened and whole blood, blood plasma and the coagulant were administrated in time to make the hemoglobin up to the level of 10 g and hematocrit 30%. The patients without timely increasing of their blood volume died of multiple system organ failures. Conclusion: The blood volume should be supplemented in time, rapidly and effectively. During the supplementation of blood volume, the principles of fast-to-slow, crystalsolution-to-colloidsolution and salinesolution-to-glucosesolution should be followed to furnish blood and oxygen with important organs, which is a key to a successful treatment.