限制性液体复苏院前抢救创伤非控制出血性休克临床观察

Clinical observation on pre-hospital first aid of limited fluid resuscitation for uncontrolled hemorrhagic shock after trauma

目的探讨限制性液体复苏院前抢救创伤非控制出血性休克的临床疗效。方法选择2010年1月—2011年9月期间创伤非控制出血性休克279例,其中127例未呼叫急救电话,由家人或外人直接送来急救中心(非院前急救组,A组)。另外152例经院前急救(院前急救组,B组),两组均采用限制性液体复苏,比较两组病死率和生存时间。结果院前急救组病死率低[院前急救组(18.42%),非院前急救组(31.50%)]、生存时间长[院前急救组(5.14±1.7)h,非院前急救组(2.5±0.8)h],两组差异均具有统计学意义(P<0.05)。结论院前急救能降低病死率,延缓死亡时间,加强"黄金1小时"的抢救,是提高抢救成功的关键。

[Objective]To study the clinical effect of pre-hospital first aid of limited fluid resuscitation on uncontrolled hemorrhagic shock after trauma. [Methods]279 patients with uncontrolled hemorrhagic shock after trauma from January 2010 to September 2011 were collected.127 cases did not have emergency telephone call,and were taken to emergency center by family members or outsiders（no pre-hospital first aid group,group A）.152 cases were treated by pre-hospital first aid（pre-hospital first aid group,group B）.All patients of two groups were given limited fluid resuscitation,the mortality and survival time of two groups were compared. [Results]The mortality of group B（18.42%） was lower than that of group A（31.50%）,the survival time of group B（5.14±1.7） h was longer than that of group A（2.5±0.8） h,and the differences were significant（P0.05）. [Conclusion]The pre-hospital first aid can reduce the mortality and delay time of death.Strengthening the emergency treatment within the first golden hour is the key to enhance the success rate of rescue.