地震中肢体挤压伤的液体治疗

Fluid resuscitation in treatment of limb crush injury after Wenchuan earthquake

目的评价静脉补液对预防肢体挤压伤后肾功能衰竭发生的重要性。方法分析解放军第四五二医院收治的11例汶川地震肢体挤压伤伤员临床资料。结果伤员被废墟下掩埋平均时间（10．90±4．81）h（2～18h），震后（96．18±26．59）h（24～143h）经直升机转运至中心医院。入院第1天血清肌酸激酶峰值（22327．3±26881．0）U／L（1500～102400U／L）。入院24h液体入量可以达到12000mL。无死亡和肾功能衰竭发生。结论尽早、快速、大量静脉补液可以预防挤压综合征发生肾功能衰竭。

Objective To evaluate the effects of fluid resuscitation on prevention of acute renal failure after limb compression injury caused by the Wenchuan earthquake. Methods We analyzed the clinical and laboratory data of 11 patients with crush-syndrome who had been transferred to No. 452 Hospital of Air Force after the Wenchuan earthquake. Results The patients were buried under collapsed houses for an average of 10. 9 ±4.81 （range, 2 to 18） hours. They were transferred to the destination hospital 96. 18 ±26.59 （range, 24 to 143） hours after the earthquake. Peak serum creatine kinase ranged from 1,500 to 102, 400 （22327.3±26881） U/L. Initial fluid resuscitation of admission reached above 12000 mL. No death or renal failure happened. Conclusion Prompt and adequate fluid resuscitation can prevent acute renal failure after limb compression injury after an earthquake.