限制性液体复苏救治严重腹部创伤合并失血性休克临床观察

Clinical Observation of Limited Fluid Resuscitation in the Treatment of Se-vere Abdominal Trauma and Hemorrhagic Shock

目的探究限制性液体复苏救治腹部创伤合并失血性休克的临床效果。方法整群选取自2014年7月—2015年7月该院收治的98例严重腹部创伤休克的患者为研究对象。随机分为观察组和对照组,每组49人。观察组应用限制性液体复苏的方法治疗严重腹部创伤合并失血性休克的患者,对照组则采用常规的体液复苏救治方法来进行救治。分析对比两组患者的疗效,并发症情况,以及死亡率。结果观察组的平均输液量是(2226±325)m L,急性呼吸窘迫综合征(ARDS)的发生率为10.20%,急性肾功能衰竭(ARF)的发生率为10.20%,脓毒血症发生率为18.16%,弥漫性血管内凝血(DIC)发生率为14.29%,病死率为4.08%,对照组平均输液量为(3498±592)m L,ARDS发生率为18.37%,,ARF发生率为10.20%,脓毒血症发生率为16.33%,DIC发生率为22.4%,病死率为10.20%。两组对比,除ARF发生率的差异无统计学意义,P>0.05,其余各项P<0.05,差异有统计学意义。结论限制性体液复苏救治严重腹部创伤合并失血性休克能够降低一般休克后并发症的发生,且死亡率也较传统体液复苏方法明显提高,预后改善情况良好,其综合复苏效果显著,值得临床推广。

Objective To explore the treatment of restrictive fluid resuscitation abdominal trauma and hemorrhagic shock clinical results. Methods 98 patients with severe abdominal trauma shock selected from July 2014 to July 2015, admitted to our hospital for the study. Randomly divided into two groups：the observation and control group, 49 in each group. Observa-tion group method restricted fluid resuscitation in the treatment of severe abdominal trauma patients with hemorrhagic shock, the control group using conventional fluid resuscitation approach to treatment. Comparative analysis of the efficacy of two groups of patients, complications, and mortality. Results The average amount of fluid in the observation group was （2226 ± 325） ml, acute respiratory distress syndrome （ARDS） 10.20% incidence of acute renal failure （ARF） incidence of 10.20%, sepsis occurs was 18.16%, the occurrence of disseminated intravascular coagulation （DIC） was 14.29%, mortality rate was 4.08%in the control group, the average amount of fluid （3498 ± 592） ml, ARDS incidence rate was 18.37%,, ARF 10.20%, sepsis rate was 16.33%, DIC rate was 22.4%, the mortality rate was 10.20%. Compare the two groups, no signifi-cant difference in addition to the incidence of ARF difference outside, P〉 0.05, the rest of the P﹤0.05, were statistically significant. Conclusion Restrictive fluid resuscitation in treating severe abdominal trauma and hemorrhagic shock can re-duce the incidence of complications after general shock and fluid resuscitation mortality rate than traditional methods signif-icantly improved, and also the prognosis, its overall effect is remarkable recovery, worthy of promotion .