失血性休克128例急救体会

First-aid in 128 cases with hemorrhagic shock

目的总结失血性休克的急救经验。方法 128例失血性休克病人均给予院前早期现场止血,静脉套管针双通道扩容,使用平衡盐及代血浆—万汶(Woluven),在急救中心做好术前准备送手术室,对于经快速扩容(含输血)未见好转者在急诊手术室行紧急救命手术。结果 128例失血性休克,急救成功116例,成功率为90.63%。结论院前早期有效扩容能很好地改善病人的血压,争取到宝贵的手术时机;急诊手术室手术能缩短绿色通道,减少术前准备的时间,避免过多搬动危重病人,争取宝贵的分分秒秒,减少死亡率及严重的并发症。

Objective To analyze 128 cases presented with hemorrhagic shock in the 120 emergency center of Haikou from May 2009 to April 2010 and study the treatment retrospectively,which lead to the advance of constructive comments on first-aid in hemorrhagic shock.Methods 128 cases with hemorrhagic shock were given pre-hospital treatment to keep them from bleeding on the spot and were used IV catheter double-channel for expansion with balanced salt solution and plasma substitute blood namely woluven,then made preparation for operation in the emergency center before surgery.Some cases with rapid expansion including blood transfusion but taking no effects were sent to emergency operating room for life-saving emergency surgery.Results 116 out of 128 cases with hemorrhagic shock were treated successfully by first-aid,the success rate is 90.63%.Conclusion Early and effective pre-hospital expansion could greatly improve the patient＇s blood pressure,which could gain valuable time for operation;the emergency surgery in operating room can shorten the green channel,reduce preoperative preparation time,avoid moving the patients frequently,and reduce the mortality and serious complications.