ISS、补液量、BE对创伤失血性休克患者的影响

INFLUENCE OF ISS,FLUID VOLLUME AND BE TO THE TRAUMATIC SHOCK PATIENTS.

目的:探讨ISS、补液量、BE对创伤失血性休克患者的影响。方法:对112例创伤失血性休克患者的伤情、救治过程及转归进行回顾性的研究,对患者的损伤严重度评分(ISS)、受伤后3h内的液体入量、伤后6h碱缺失(BE)与器官功能衰竭(OD)、死亡率的关系进行分析。结果:(1)ISS分值<16、16~24、≥25时的OD率分别为3·70%、32·26%、61·76%;死亡率分别为0、19·35%、44·12%,差异均有统计学意义(P<0·01)。(2)输液量<1000ml、1000~2000ml、2000~3000ml、>3000ml,OD率分别为0、17·64%、31·43%、59·38%,差异有统计学意义(P<0·05);死亡率分别为0、5·88%、14·29%、31·25%,差异无统计学意义(P>0·05)。(3)BE值在<-12、-6^-12、2^-5时的OD率分别为73·68%、32·00%、6·25%;死亡率分别为52·63%、20·00%、0%:OD率、死亡率差异均有统计学意义(P<0·05)。结论:在影响创伤失血性休克患者的因素中,创伤的严重程度评分、最初3h的补液量及伤后6h血气分析的碱缺失程度均对其有明显影响。

Objective:To investigate the related factors that predict the outcome of traumatic shock.Methods:112 patients with traumatic shock were studied retrospectively and analyzed by χ2 -test and analysis of variance.Result:While the score of ISS was<16,16～24,≥25,the rate of OD was 3.70%,32.26%,61.76%in 6 h after the injury, Rate of data was 0,19.35%,44.12% respectively.The proportion of patients who OD and died was significant defference by ISS(P<0.05).While the volume of fluids after 3 h injuried is <1 000 ml,1 000～2 000 ml,2 000～3 000 ml,>3 000 ml,rate of OD was 0,17.64%,31.43%,59.38%,and rate of the death was 0,5.88%,14.29%,31.25% respectively. The proportion of patients who OD was significant defference(P<0.05).While the range of BE is 2～ -5,-6～ -12, <-12.The rate of OD was 6.25%,32.00%,73.68%, and rate of the death was 0,20.00%,52.63% respectively. The proportion of patients who OD and died was significant defference(P<0.05).Conclusion:The score of ISS,the volume of fluids in 3 h after the injur,and the range of BE in 6 h after the injury are the most important factor to predict the outcome of traumatic shock.