74例创伤性休克救治的回顾性分析

A retrospective review on treatment of 74 cases of traumatic shock

目的:探讨严重多发伤伴休克的临床救治及并发症的防治法。方法:回顾性分析我院严重多发伤伴休克74例病例资料。伤后早期容量复苏晶体液以平衡盐液为主,适量输血及补充胶体液。70例接受手术治疗,所有患者接受了ICU监护及治疗。结果:发生全身炎性反应综合征(SIRS)36例,急性肺损伤及成人呼吸窘迫综合征(ARDS)24例,多器官功能不全综合征(MODS)14例,应激性溃疡12例。治愈69例(93.3%);死亡5例(6.7%)。结论:开辟绿色生命通道,遵循CRASHPLAN的检查程序,早期合理的容量复苏,正确掌握手术时机和方法等均为严重多发伤伴休克救治的重要环节。

Objective To investigate the treatment of severe multi-trauma companied with shock and the prevention of its complication. Methods ： A retrospective review was undertaken on the clinical data of 74 cases of severe multi-trauma with shock in the hospital.During the early period of post-trauma, lactated Ringer＇s solution was used as major fluid resuscitation,At the same time,proper volume of blood and colloid were injected. 70 patients received operation and all were cared for in ICU.Results SIRS occurred in 36 cases,ALI/ARDS in 24 cases, MODS in 14 cases and stress ulcer in 12 cases. Mortality is 6.7% [5 cases].Conclusion： Building a blue-life-channel, following CRASHPLAN examination procedure, carrying out reasonable fluid resuscitation in early period, seizing opportunity and method of operation correctly are all important taches in treatment of severe multi-trauma with shock. It is imperative that we should earlier build a medical group specializing in traumatic treatment in hospitals.