早期使用限制性液体复苏治疗重度骨盆骨折并创伤失血性休克的疗效评价

Evaluation of effect of early limited fluid resuscitation in treatment of severe pelvic fracture accompanied with traumatic hemorrhagic shock

目的评价重度骨盆骨折并创伤失血性休克早期采用限制性液体复苏的治疗效果，以提高治愈率。方法总结2002年1月-2006年12月急诊收治的重度骨盆骨折并创伤出血性休克患者96例，其中常规液体复苏组55例，限制性液体复苏组41例，对其创伤严重程度、休克程度、复苏开始时间、输入液量进行统计学分析，对比两组的治疗效果。结果常规液体复苏组输液量为（3432±1156）ml，治愈率为64％，死亡率为36％；限制性液体复苏组输液量为（2685±524）ml，治愈率为83％，死亡率为17％。两组比较，差异有统计学意义（P〈0．05）。结论重度骨盆骨折并创伤失血性休克采用限制性液体复苏方法救治可提高治愈率。

Objective To evaluate the effect of early limited fluid resuscitation in treatment of severe pelvic fracture accompanied with traumatic hemorrhagic shock. Methods A retrospective study was done on 96 patients with severe pelvic fractures accompanied with traumatic hemorrhagic shock admitted into hospital from January 2002 to December 2006. Of all, 55 patients （ routine resuscitation group） were dealt with routine fluid resuscitation and 41 （limited resuscitation group） with limited fluid resuscitation. The injury severity, degree of shock, start time of resuscitation, transfusion volume were statistically analyzed and compared in two groups. Results Routine resuscitation group received transfusion volume of （3 432 ± 1 156） ml, with cure rate of 64% and mortality rate of 36% ; while limited resuscitation group received transfusion volume of （2 685 ±524） ml, with cure rate of 83% and mortality rate of 17%. There was statistical difference between both groups （P 〈0.05）. Conclusion Limited fluid resuscitation can improve cure rate of severe pelvic fracture accompanied with traumatic hemorrhagic shock.