限制性液体复苏救治创伤失血性休克的疗效研究

Clinical effort of restricted fluid resuscitation methods for traumatic hemorrhagic shock （HTS）

目的探讨不同液体的复苏方法对救治创伤失血性休克（HTS）的临床效果，总结临床经验。方法用不同液体复苏方法救治HTS患者300例，按入院的先后顺序随机分为限制性液体复苏组（A组）、高渗盐溶液复苏组（B组）和常规液体复苏组（c组），每组100例，对三组患者复苏前后的血清乳酸值、碱剩余值、输入液体量、存活率，进行统计学分析。结果A组、B组与c组间液体输入量比较差异有统计学意义，P〈0．05，A组与B组间差异有统计学意义P〈0．05，A组、B组与c组间复苏前的碱剩余值、血乳酸值比较无明显差异P〉0．05，无统计学意义；复苏12、24h的碱剩余值、血乳酸比较存差异有统计学意义，P〈0．05。A组、B组与c组间存活率比较存差异有统计学意义P〈0．05。结论采用限制性液体复苏方法对治疗HTS均有显著疗效，能改善组织器官灌注，明显增加循环血量，降低死亡率，提高治愈率。

Objective To explore different liquids recovery methods for traumatic hemorrhagic shock （HTS）. Methods 300 patients admitted in between June 2008 and December 2012 were randomly divided into three groups based on their respective time to be admitted, group A （restricted fluid resuscitation）, group B （hypertonic saline solution resuscitation）, and group C （conventional fluid resuscitation group）, with 100 in each group. A comparison was made between the groups on serum lactate, base excess values, and amount of the liquid injected, survival rate. Results A statistical difference was reflected between the three groups , P 〈0.05; a significant difference was also reflected between group A and group B, P 〈0.05; a statistical difference was found between group A/group B and group C on base excess values before recovery; no significant difference was found for blood lactate values , P 〉 0.05; a statistical difference was also found between group A, group B and group C in survival rate , P 〈0.05. Conclusion Fluid resuscitation methods used for HTS demonstrated carry out significant effort which may improve tissue and orzan perfusion, increase blood circulation, and reduce mortality.