液体复苏在创伤失血性休克急救应用中的探讨

The discussion on application of fluid resuscitation in rescue of hemorrhagic traumatic shock

目的比较限制性和充足液体复苏在创伤失血性休克急救中的应用效果。方法将367例创伤失血性休克患者随机分为2组:A组180例,实行限制性液体复苏;B组187例,实行充足液体复苏。比较2组临床效果及凝血酶原时间(PT)、病死率等。结果 A组液体量(1 250±330)m L,PT(11.2±1.6)s,病死率23.33%,并发症发生率为18.84%;B组液体量(2 890±560)m L,PT(16.1±1.2)s,病死率37.61%,并发症发生率为37.61%。2组输液量、PT时间、病死率及并发症发生率比较差异均有统计学意义(P均<0.05)。结论限制性液体复苏在创伤失血性休克的救治中效果更好,能够降低患者病死率及并发症发生率。

Objective It is to compare the clinical effect of limited fluid resuscitation and adequate fluid resuscitation for trauma uncontrolled hemorrhagic shock.Methods 367 cases of patients with traumatic shock randomly divided into two groups：Group A （180 cases） with limited fluid resuscitation early;Group B （187 cases） with adequate fluid resuscitation.Compare the clinical effect, prothrombintime （ PT） , and case fatality rate of the two groups.Results In Group A, the liquid volume was （1250 ±330） mL, PT was （11.2 ±1.6） s, the case fatality rate was 23.33% and the incidence of complications was 18. 84%;in Group B, the liquid volume was （2890 ±560） mL, PT was （16.1 ±1.2）s, the case fatality rate was 37.61%and the incidence of complications was 37.61%.There were significant differences in transfusion volume, PT, the case fatality rate and the incidence of complications between both groups （all P〈0.05）.Conclusion Limited fluid resuscitation in the treatment of uncontrolled hemorrhagic shock trauma is better, and can reduce the case fatality rate, and reduce the incidence of later complications.