限制性液体复苏在休克伴TIC患者中应用的临床研究

Clinical Study of restrictive fluid resuscitation in patients with shock and TIC

目的观察限制性液体复苏方式在休克伴创伤性凝血功能异常(TIC)患者中应用的临床疗效。方法选取医院收治的符合休克伴TIC诊断标准的患者69例,32例应用常规液体复苏予以抢救治疗(常规组),37例予以限制性液体治疗(限制组),对2组患者的凝血功能、血气分析、存活率、伤后6个月生活质量优良率进行比较。结果复苏后90 min、150 min限制组p H值、Pa O2测定值显著高于常规组,Pa CO2值显著低于常规组(P<0.01);限制组APTT、PT、TT测定值显著低于常规组(P<0.01)。限制组存活率显著高于常规组(P<0.05);2组伤后6个月生活质量优良率比较差异无统计学意义(P>0.05)。结论采用限制性液体复苏抢救治疗休克伴TIC患者,凝血功能、血气分析指标改善明显,患者存活率提高,临床疗效确切。

Objective To investigate the clinical effect of restricted fluid resuscitation in patients with shock and TIC. Methods 69 patients who met the diagnostic criteria of shock and TIC were retrospectively reviewed. 32 patients were treated with conventional fluid resuscitation（ conventional group） and 37 patients received limited fluid therapy（ restricted group）. The coagulation function,blood gas analysis,survival rate and quality of life of 6 months after injury were compared between two groups. Results After 90 min、150 min,the values of p H and Pa O2 in the restricted group were significantly higher than those in the conventional group（ P〈0. 01）. The values of APTT,PT and TT in the restricted group were significantly lower than those in the conventional group（ P〈0. 01）. The survival rate in restricted group was significantly higher than the conventional group（ P〈0. 05）. There was no significant difference in the quality of life between the two groups at 6 months after injury（ P〉0. 05）. Conclusion By the use of restrictive liquid resuscitation to treat shock patients with TIC,the blood coagulation function,blood gas analysis index and the survival rate of patients were improved obviously. The clinical curative effect was exact.