限制性液体复苏在急性硬膜下血肿清除术中的应用研究

The application of Limited fluid resuscitation in the patients with acute subdural hematoma

目的:探讨限制性液体复苏在急性硬膜下血肿清除术中的应用研究。方法:选择我院急性硬膜下血肿清除术患者100例,随机分为对照组和实验组,各50例。实验组采用高渗氯化钠羟乙基淀粉40注射液与乳酸钠林格氏液以1∶1的比例静脉输注;对照组采用常规液体复苏治疗。采用GCS评分、GOS评分及HR、MAP、ICP和CVP对比评价两组临床效果。结果:实验组输液量(2 580±151)mL明显少于对照组(3 359±160)mL,两组比较差异有统计学意义,P<0.05;两组患者术后1、2、3、5、7天GCS评分,术后3个月、6个月GOS评分,差异均具有统计学意义,P<0.05;两组患者ICP在去骨瓣后10 min(T2)、止血完成(T3)、手术结束(T4)时比较,差异均具有统计学意义,P<0.05。结论:限制性液体复苏在急性硬膜下血肿清除术中的应用,有助于改善患者的预后,降低术中不良反应的发生。

Objective： To discuss the application of limited fluid resuscitation in the patients with acute subdural hemato-ma.Methods： 100 patients with acute subdural hematoma were randomly divided into control and experimental groups,and each group had 50 cases in our hospital.The experimental group was treated with hypertonic saline hydroxyethylstarch 40 sodium chloride injection and sodium lactate Ringer＇s solution intravenously in 1∶ 1 ratio;the control group was treated with conventional fluid resuscitation.The clinical results were evaluated by GCS score,GOS score,HR,MAP,ICP and CVP.Results： The infusion of experimental group（2 580 ± 151） mL was significantly less than that in the con-trol group（3 359 ± 160） mL,the difference was statistially significant,with P 0.05;postoperative GCS score andGOS score had statistically significant,with P 0.05;ICP in the two groups at 10 minutes after craniectomy（T2）,com-plete hemostasis（T3） and the end of surgery（T4） had statistical differences,with P 0.05.Conclusion： The applica-tion of limited fluid resuscitation in the patients with acute subdural hematoma can help to improve prognosis and reduce the incidence of intraoperative adverse events.