限制性液体复苏在急性上消化道出血致失血性休克中的临床应用

Clinical application of limited fluid resuscitation for hemorrhagic shock caused by acute upper gastrointestinal hemorrhage

目的:探讨限制性液体复苏在急性上消化道出血致失血性休克中的临床应用。方法:回顾性分析57例急性上消化道出血致休克患者的病历资料,其中常规液体复苏组27例,限制性液体复苏组30例,对复苏后2组患者的血乳酸、血气剩余碱值(BE)、血红蛋白及血小板计数等指标进行统计学分析。结果:限制组患者复苏后的血红蛋白、血小板计数、血乳酸、BE值与常规组相比较,差异均有统计学意义(P<0.05)。结论:对于急性上消化道出血致失血性休克患者,早期限制性液体复苏可有效维持重要脏器的血流灌注,改善全身灌注指标。

Objective：To investigate the effect of clinical application of limited fluid resuscitation on hemorrhagic shock caused by acute upper gastrointestinal hemorrhage. Methods： Clinical data of 57 patients with hemorrhagic shock caused by acute upper gastrointestinal hemorrhage were analyzed retrospectively. Patients were divided randomly into conventional fluid resuscitation group （27 cases） and limited fluid resuscitation group （30 cases）. Blood lactate, blood gas, base excess values （BE） ,hemoglobin and platelet counts in two groups were statistically analyzed after fluid resuscitation. Results： The blood lactate, blood gas, base excess values （BE）, hemoglobin and platelet count of limited group were significantly superior when compared with those of the conventional group （P 〈0. 05）. Conclusions： For patients with hemorrhagic shock caused by acute upper gastrointestinai bleeding, early limited fluid resuscitation can maintain effective perfusion to the vital organs, and win valuable time for further treatments, and i/-nprove the long-term prognosis.