损伤控制性复苏对严重多发伤患者创伤性凝血障碍的影响

Effect of Injury-controlled Resuscitation on Traumatic Coagulation Disorder in Patients With Severe Multiple Injuries

目的研究损伤控制性复苏对严重多发伤患者创伤性凝血障碍的影响。方法选取我院在2019年10月—2020年10月收治的64例严重多发伤患者作为研究对象,根据随机数字表法将其分为两组,每组32例。对照组患者采用传统复苏治疗,观察组患者采用损伤控制性复苏法治疗,对比两组的临床指标、创伤性凝血障碍发生率及病死率。结果(1)观察组的胶体液量、晶体液量、浓缩红细胞量均少于对照组,血浆量明显多于对照组,差异有统计学意义(P<0.05);(2)与对照组相比,观察组的低体温时间、凝血功能时间、酸中毒时间、住院时间均相对较短,出血量更少,差异有统计学意义(P<0.05);(3)与对照组相比,观察组的创伤性凝血障碍发生率和病死率更低,差异有统计学意义(P<0.05)。结论对严重多发伤患者实施损伤控制性复苏可减少出血量,及时纠正酸中毒和低体温,在短时间内改善患者的凝血功能,降低创伤性凝血障碍的发生风险和死亡风险,缩短患者的住院时间,因此,此种复苏方法更值得在临床上进一步推广和应用。

Objective To study the effect of injury-controlled resuscitation on traumatic coagulation disorder in patients with severe multiple trauma.Methods A total of 64 patients with severe multiple trauma admitted to our hospital from October 2019 to October 2020 were selected as the research objects,and they were divided into two groups according to the random number table method,with 32 patients in each group.Patients in the control group were treated with traditional resuscitation,and patients in the observation group were treated with injury-controlled resuscitation.The therapeutic effect,incidence of traumatic coagulation disorder and patient mortality were compared between the two groups.Results(1)The volume of colloid,crystalloid,and concentrated red blood cells in the observation group were all lower than those in the control group,and the plasma volume was significantly higher than that in the control group,and the difference was statistically significant(P<0.05);(2)Compared with the control group,the hypothermia time,coagulation function time,acidosis time,and hospitalization time of the observation group were relatively shorter,and the amount of bleeding was less,and the differences were statistically significant(P<0.05);(3)The incidence and mortality of traumatic coagulation disorders were lower in the observation group than in the control group,and the differences were statistically significant(P<0.05).Conclusion Damage-control resuscitation in patients with severe multiple injuries can reduce blood loss,correct acidosis and hypothermia in a timely manner,improve coagulation function in a short period of time,reduce the risk of traumatic coagulation disorders and the risk of death,and shorten the length of hospitalization for patients.Therefore,this resuscitation method is more worthy of further promotion and application in clinical practice.