限制性液体复苏与积极液体复苏在抢救多发伤伴失血性休克患者中的临床效果对比研究

A comparative study on the clinical effect of limited fluid resuscitation and active fluid resuscitation in the treatment of patients with multiple trauma and hemorrhagic shock

目的比较限制性液体复苏与积极液体复苏在抢救多发伤伴失血性休克患者中的临床效果。方法 86例多发伤伴出血未控制的失血性休克患者随机分为两组,分别采用常规积极液体复苏(积极组)及限制性液体复苏(限制组),比较两组患者术前凝血酶原时间(PT)及部分凝血活酶时间(APTT),剩余碱(BE)、复苏所用的液体输入量、术前复苏时间以及急性呼吸窘迫综合征(ARDS)、多脏器功能障碍综合征(MODS)发生率和死亡率。结果限制组患者液体输入量、术前复苏时间、PT、APTT、BE等指标与积极组比较差异均有显著性(P<0.05);限制组患者住院期间ARDS发生率、MODS发生率及死亡率分别为16.28%、9.30%及11.63%,均低于积极组的34.88%、25.58%及27.91%(P<0.05)。结论对于出血未控制前的多发伤伴失血性休克患者,采用限制性液体复苏能够缩短术前复苏时间,降低ARDS、MODS等并发症发生率,改善患者的预后。

ObjectiveTo compare the clinical effect of limited fluid resuscitation and active fluid resuscitation in the treatment of multiple trauma with hemorrhagic shock.Method86 patients with uncontrolled hemorrhagic shock were randomly divided into two groups, respectively adopted conventional positive fluid resuscitation （positive group） and restricted restricted fluid resuscitation （restricted group）, compared PT, APTT, BE, liquid input for recovery, the incidence of ARDS and MODS, and mortality of the two groups before the operation.ResultThere were signiifcant differences in the amount of liquid input, APTT, PT, BE and other indicators of the patients in the restriction group （P〈0.05）. The incidence of ARDS, MODS and mortality in restricted goup were 16.28%, 9.30% and 34.88%, respectively, and were lower than positive group （34.88%, 25.58%, 27.91%） （P〈0.05）.ConclusionFor the patients bleeding before multiple injury with hemorrhagic shock, with limited lfuid resuscitation can shorten preoperative recovery time, reduce the incidence of ARDS and MODS, improve the patient＇s prognosis.