碱缺失在创伤性休克中的临床研究

Clinical research of base excess in traumatic shock

目的探讨碱缺失的动态变化与创伤性休克病情转归的关系。方法回顾性分析68例ICU创伤性休克患者临床资料,根据疾病转归,将患者分为存活组(56例)和死亡组(12例),比较2组病人复苏即刻0h,6h,12h,24h碱缺失的差异;根据12h碱缺失程度,将患者分为:A组(轻度碱缺失,44例)和B组(中重度碱缺失,24例),比较2组病人并发ARDS,MODS及28d死亡率的差异。结果存活组与死亡组0h碱缺失无统计学差异(P>0.05),而经复苏治疗后动态观察:6h,24h 2组碱缺失有明显统计学差异(P<0.05);12h碱缺失2组有显著统计学差异(P<0.01);12h A组并发ARDS、MODS及28d死亡率明显低于B组(P<0.05)。结论动态监测碱缺失程度对提高创伤性休克患者救治成功率,降低并发症及死亡率,具有积极的临床意义。

Objective To explore the relationship between the changes of base and the prognosis of traumatic shock. Methods 68 cases in ICU patients with traumatic shock were retrospectively analyzed and divided into survival group （56 cases） and death group （12 cases） According to the level of base excess 12 hours after resuscitation, the patients were divided into group A （mild base deficit, n=44）, group B （moderate and severe base deficit, n=24）, and then incidence rates of ARDS and MODS in two groups together with the difference of fatality rates in 28 days were compared. Results There was no difference in base excess between survival and death groups immediately after resuscitation （P 〉 0.05）; significant differences in 6h and 24h（P 〈 0.05）,and more notable differences in 12h（P 〈 0.01）. Incidence rates of ARDS,MODS as well as the fatality rates in 28 days of group A were clearly lower than that in group B（P 〈 0.05）. Conclusion Dynamic monitoring of the levels of base is clinically positive to improve lifesaving rate and to reduce complications and mortality rate of patients with traumatic shock.