摘要
目的探讨限制性液体复苏治疗策略对创伤失血性休克患者预后的影响。方法选取2014年1月-2015年12月在华北石油管理局总医院治疗的创伤失血性休克患者共67例，根据创伤失血性休克患者液体复苏方法不同将其分为观察组（36例）和对照组（31例），观察两组患者凝血指标（TT、APTT、PLT）、血气分析指标（氧合指数、血乳酸）和复苏效果（病死率和MODS、ARDS并发症发生率）。结果观察组复苏6h血乳酸低于对照组，氧合指数高于对照组，差异有显著统计学意义（P〈0．05）。凝血指标复苏6h观察组APTT、PT低于对照组，PLT高于对照组，差异有统计学意义（P〈0．05）。观察组患者病死率以及MODS、ARDS并发症发生率均显著低于对照组（P〈0．05）。结论限制性液体复苏治疗创伤失血性休克具有良好的临床疗效，可以降低病死率和并发症发生率。
Objective To study the curative effects of restrictive liquid resuscitation in patients with hemorrhagic traumatic shock （HTI）. Methods 67 patients with HTI were randomly divided into 2 groups： test group （n=36） undergoing fluid infusion at a high speed first and then at a low speed and a restricted quantity of transfusion so as to maintain the systolic blood pressure （SBP） at 70 -90 mmHg, mean arterial pressure （MAP） at 50 - 60 mmHg, and central venous pressure （CVP） 〉 2.18 mmHg; and control group （n=31） undergoing early, rapid and adequate fluid resuscitation. Six hours later the prothrombin time （PT）, activated partial thromboplastin time （APTT）, blood platele （PLT）, partial pressure of oxygen/fraction of inspiration O： ratio （PaOJFiO2）, blood lactic acid （LA） were tested. The mortaly and incidence rastes of multiple organ dysfunction syndrome （MODS） and acute respiratory distress syndrome （ARDS） were calculated. Results Six hours after the beginnning of treatment, the PLT and PaOJFiO2 of the test group were both significantly higher than those of the control group （both P〈0.05）. The LA, APTT, PT, ease mortaly and incidence rates of MODS and ARDS of the test group were all significantly lower than those of the control group （all P〈 0.05）. Conclusion The treatment method of restrictive liquid rresuscitation achieves good curative effects and effectively reduces the ease fatality rate and complication rates in the patients with HTI.
出处
《中国急救复苏与灾害医学杂志》
2016年第9期849-851,共3页
China Journal of Emergency Resuscitation and Disaster Medicine
关键词
限制性液体复苏
失血性休克
创伤
Restrictive fluid resuscitation： Hemorrhagic traumatic shock （HTI）
