不同的血压控制在早期失血性休克限制性液体复苏中的治疗效果

Curative effect of limited fluid resuscitation in early hemorrhagic shock patients with different blood pressures

目的探讨限制性液体复苏时维持不同的血压水平对创伤失血性休克早期的治疗效果。方法回顾性分析维持两种不同的血压水平对患者的死亡率、存活患者并发症发生率、血乳酸、凝血酶原时间、血红蛋白、血小板计数及血细胞比容等指标在早期失血性休克限制性液体复苏中的影响。结果p40组死亡率15．69％，存活患者并发症发生率16．28％；p60组死亡率28．57％，存活患者并发症发生率35．00％。两组死亡率及存活患者并发症发生率比较差异均有统计学意义（P〈0．05）。两组血乳酸、凝血酶原时间、血红蛋白、血小板计数、血细胞比容及血红蛋白比较差异均有统计学意义（P〈0．05）。结论早期失血性休克患者限制性液体复苏过程中平均动脉压（MAP）维持在40～60mmHg之间，可以降低患者死亡率，提高存活率，降低存活患者并发症的发生率，改善预后。

Objective To investigate the curative effect of limited fluid resuscitation in early hemorrhagic shock patients with different blood pressures. Methods To retrospectively analyze the difference of death rate, incidence rate of complications in the survivors, blood lactic acid, prothrombin time, hemoglobin, platelet count and hematocrit in early hemorrhagic shock patients with different blood pressures. Results Death rate of p40 and p60 groups was 15.69% and 28.57% ; incidence rate of complications in p40 and p60 survivors was 16.28% and 35.00% , and there were statistical differences （P 〈 0.05 ）. There were significant differences in blood lactic acid, prothrombin time, hemoglobin, platelet count and hematocrit between two groups （ P 〈 0.05 ）. Conclusion Keeping 40 - 60 mm Hg blood pressure can decrease death rate and incidence rate of complications in the survivors, raise survival rate and improve the prognosis in early hemorrhagic shock patients during limited fluid resuscitation.