限制性液体复苏在创伤失血性休克中的临床应用

Clinical application of restrictive fluid resuscitation in the treatment of traumatic hemorrhagic shock

目的探讨限制性液体复苏在创伤失血性休克中的临床应用效果。方法2013年1月至2015年12月，泰州市人民医院救治的创伤失血性休克患者78例，随机分为限制性液体复苏组和常规液体复苏组，观察不同液体复苏方法对剩余碱、血乳酸、凝血功能、输液量、病死率及并发症的影响。结果限制性液体复苏组患者病死率、并发症发生率明显低于常规液体复苏组（P〈0．05）；限制性液体复苏组患者凝血酶原时间、部分凝血酶原时间、输液量、剩余碱、血乳酸等指标与常规液体复苏组比较差异具有统计学意义（P〈0．05）。结论创伤失血性休克患者采用限制性液体复苏可改善并维持重要组织器官灌注，降低患者病死率及并发症的发生。

Objective To discuss the clinical application of restrictive fluid resuscitation for shock patients resulted from traumatic exsanguination. Methods A total of 78 patients with hemorrhagic shock admitted from January 2013 to December 2015 were randomly （random number） divided into two groups, namely conventional fluid resuscitation group and restrictive fluid resuscitation group. The changes of prothrombin time （ PT）, activated partial thromboplastin time （ APTr）, base excess （ BE）, blood lactic acid （BLA）, amount of liquid required for successful resuscitation, mortality rate and morbidity rate were compared between the two groups. Results The PT, APTT, BE, BLA, amount of liquid infused for successful resuscitation, mortality rate and morbidity rate in restrictive fluid resuscitation group were lower than those in conventional fluid resuscitation group （P 〈 0. 05 ）. Conclusions Restrictive fluid resuscitation for patients with traumatically hemorrhagic shock could improve and maintain perfusion of important organs, thus reducing mortality and morbidity.