创伤性失血性休克液体复苏疗效观察

Traumatic Hemorrhagic Shock Resuscitation Efficacy

目的比较限制液体复苏与积极液体复苏救治创伤失血性休克的临床效果。方法将符合创伤失血性休克患者随机分为限制液体复苏组、积极液体复苏组、高渗组、限制性液体高渗组,通过观察手术前患者死亡率、术后24h内死亡率及多器官功能衰竭(MODS)、急性呼吸窘迫综合征(ARDS)的发生率及等指标进行比较分析。结果积极液体复苏组死亡率为32.5%,ARF3例,DIC4例,ARDS5例,MODS4例;高渗积极液体复苏死亡率为30%,ARF2例,DIC2例,ARDS3例,MODS3例;限制性液体复苏组死亡率为20%,ARF1例,DIC1例,ARDS2例,MODS2例;限制高渗液体复苏组死亡率为17.5%,ARF1例,DIC0例,ARDS1例,MODS0例。结论限制性高渗液体复苏治疗能降低未控制出血的患者的死亡率,限制性高渗液能减少MODS和ARDS的发生率,提高其治愈率。

Objective To explore the therapeutic effect of limited fluid resuscitation and Aggressive fluid resuceitafon in traumatic hemorrhagic shock.Methods Divided hemorrhagic shock trauma patients randomly into limited fluid resuscitation recovery group,aggressive fluid resuceitafon,hypertonic group,limited liquid hypertonic Group,Observe the preoperative patient death rate,last 24 hours of inner death rate and the occurrence rate of multiple organ fail（MODS）,impatient embarrassed breath synthesis collect（ARDS）and wait for an index to carry out parallel analysis.Results Limited fluid resuscitation group mortality rate was 32.5%,ARF 3 cases,DIC 4 cases,ARDS 5 cases,MODS 4 cases;hypertonic limited fluid resuscitation mortality rate was 30%,ARF 2 cases,DIC 2 cases,ARDS 3 cases,MODS 3 cases;limited fluid resuscitation group mortality rate was 20%,ARF 1 cases,DIC 1 cases,ARDS 2 cases,MODS 2 cases;restrictions hypertonic fluid resuscitation group mortality rate was 17.5%,ARF 1 cases,DIC 0 cases,ARDS 1 cases,MODS 0 cases.Conclusion Limited hypertonic fluid resuscitation treatment can reduce the uncontrolled bleeding in patients with the mortality rate,high exudate restrictive MODS and can reduce the incidence of ARDS,improve it＇s cure rate.