限制性液体复苏在产后失血性休克的应用体会

Restrictive Liquid Recovery Application Experience in Postpartum Uncontrolled Hemorrhagic Shock

目的:评价限制性液体复苏在产后失血性休克的安全性及疗效。方法:选择2010年3月-2013年6月笔者所在医院收治的54例产后失血性休克患者,其中行限制性液体复苏干预的26例设为观察组,行常规液体复苏干预的28例设为对照组,对比观察两组患者治疗后的肝肾功能变化,及血清乳酸值、血气碱剩余值。结果:观察组干预后6 h、12 h的肝肾功能指标优于对照组,差异有统计学意义(P<0.05),且观察组干预后12 h的肝肾功能指标明显优于其他时间段,差异有统计学意义(P<0.05)。两组比较干预后12 h及24 h血清乳酸值、血气碱剩余值,观察组均明显优于对照组,差异有统计学意义(P<0.05)。结论:在产后失血性休克应用限制性液体复苏对患者肝肾功能保护及内环境的稳定疗效明显优于常规液体复苏,在临床上具有较高的应用价值,值得推广应用。

Objective： To evaluate the restrictive liquid recovery in postpartum curative effect and safety of uncontrolled hemorrhagic shock.Method： 54 cases of patients with postpartum uncontrolled hemorrhagic shock were treated from March 2010 to June 2013 in author＇s hospital, which limited fluid resuscitation interventionof 26 cases for the observation group, treated with conventional fluid resuscitation intervention of 28 patients as control group, in contrast to the changes observed in liver and kidney function after treatment in two groups, and serum lactate, blood base exeessvalues.Result： Observation group 6 hours, 12 hours after intervention of liver and kidney function index was better than that of control group, the difference was statistically significant（P〈O.05）, and the observation group 12 hours after intervention of liver and kidney function index was superior to other periods, the difference was statistically signifieant（P〈0.05）.Contrast observation group and control group after the intervention of 12 h and 24 h serum lactic acid value, flesh alkali remaining observation group were significantly better than the control group, the difference was statistically signifieant（P〈0.05）.Conclusion ： In postpartum recovery of kidney function in patients with uncontrolled hemorrhagic shock applied restrictive liquid protection and internal environment stable curative effect is superior to the conventional liquid recovery, has higher application value in clinic, is worthy of popularization and application.