延迟复苏治疗活动性失血性休克临床探讨

Clinical study on delayed resuscitation in the treatment of activity hemorrhagic shock

目的：探讨延迟复苏策略治疗重症活动性失血性休克在临床的应用实践。方法：延迟复苏组（A组）,限制输晶体液和胶体液量,扩容更多地依赖输血及血浆,控制目标血压以收缩压80~90 mm Hg（1 mm Hg=0.133 kPa）为允许性低血压;传统复苏组（B组）,不限制输晶体液和胶体液量,快速进行液体复苏。输液以晶体液和胶体液为主,输血及血浆为辅助,不有意控制血压上限。结果：A组抢救成活率显著高于B组。结论：在重症加强护理病房（ICU）临床上认识重症活动性失血性休克特殊性以及治疗的特殊性。应用延迟复苏方法,有望提高该类危重患者的治愈率。

Objective：To investigate the application of clinical practice of the delayed resuscitation in the treatment of activity hemorrhagic shock.Methods：recovery of delayed resuscitation group（A group） to restrict the infusion fluid volume of crystalloid and colloid fluid in fluid resuscitation,the volume expansion rely more on blood and plasma.Blood pressure control targets for systolic blood pressure 80～90 mm Hg（1 mm Hg=0.133 kPa）,for which allows hypotension;B group,without limiting the infusion volume of crystalloid and colloid fluid,and the fluid resuscitation to be quickly.Infusion with crystalloid and colloid fluid for the based fluid,blood and plasma for the assistance,not the ceiling to control blood pressure.Results：The survival rate of A group was significantly higher than the rate of the traditional group（B group）.Conclusion：To distincte and recognise the specific characteristics of the serious uncontroled activity hemorrhagic shock,as well as the specificity of the treatment.To apply the method of delayed resuscitation,expected to improve the cure rate of such critically ill patients.