预防多器官功能障碍综合征策略救治创伤失血性休克

The Multiple Organ Dysfunction Syndrome Preventative Tactic for Traumatic Hemorrhagic Shock

目的探讨重度创伤失血性休克的救治方法。方法重度创伤失血性休克患者160例,随机分组。观察组(60例)采用预防多器官功能障碍综合征(MODS)策略,即预防性机械通气、抗炎、抗水肿、改善微循环等。对照组(100例)按常规治疗。结果观察组MODS发生率低(21.7%,42.0%,χ2=5.31,P<0.05),病死率降低(18.3%,37%,χ2=4.24,P<0.05)。两组输血量相当(t=1.865,P>0.05),观察组输液量明显减少(t=2.546,P<0.05),阴离子间隙值恢复较快(t=2.618,P<0.05)。观察组最高序贯器官衰竭估计评分较低(11.3±2.9,18.6±3.2,t=2.924,P<0.05)。结论预防MODS可能是治疗创伤性休克的有效方法。

Objective To investigate the treatment of severe traumatic hemorrhagic shock. Methods The treatment group（60 cases） use the multiple organ dysfunction syndrome（MODS） preventative tactic while the control group（ 100 cases） use routine treatment. Result The MODS incidence rate of the treatment group decreased（21.7% ,42.0% , X^2 = 5.31, P 〈 0.05 ） , so did death rate （18.3% ,37% , X^2 = 4.24 ,P 〈 0.05 ）. The intravenous blood volume was similar between the two groups（ t = 1. 865 ,P 〉 0.05 ）. The intravenous fluid volume of the treatment group decreased （ t = 2. 546, P 〈 0.05 ） , and anion gap（AG） resumed better（ t = 2. 618, P 〈 0.05 ）. The peak sequential organ failure assessment score of the treatment group is relatively low （ 11.3 ± 2.9,18.6 ± 3.2, t = 2. 924, P 〈 0.05 ）. Conclusion The MODS preventative tactic was effective for traumatic hemorrhagic shock.