摘要
目的探讨对于产科失血性休克患者的救治中,限制性液体复苏治疗策略的临床价值。方法回顾性分析2019年10月至2024年8月毕节市中医医院和毕节市七星关区中医妇幼集团收治的产科失血性休克产妇的临床资料,以液体复苏策略为分组依据,将研究对象分为观察组(实施限制性液体复苏策略,30例)和对照组(实施常规液体复苏策略,30例)。对两组产妇的出血量、补液量及输血需求进行比较分析。观察指标包括:血流动力学参数:平均动脉压(MAP)、血细胞比容(HCT)、中心静脉压(CVP)和心率(HR);凝血功能指标:凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)及纤维蛋白原(FIB)水平;临床疗效评价指标。结果与对照组产妇相比,观察组产妇的出血量、液体输入量、输血量明显更少(P<0.001)。治疗前,两组产妇血流动力学相关指标(MAP、CVP、HR、HCT)和凝血功能相关指标(PT、APTT、TT、FIB)水平相比均无显著差异。治疗后,两组产妇MAP、CVP、HCT、FIB水平升高,HR、PT、APTT、TT水平降低;且与对照组产妇相比,观察组产妇MAP、CVP、HCT、FIB水平明显更高(P<0.05),HR、PT、APTT、TT水平明显更低(P<0.05)。与对照组比较,观察组产妇的临床治疗总有效率明显更高(96.67%vs.80.00%,P<0.05)。结论对于产科失血性休克患者的救治中,限制性液体复苏治疗策略可有效减少出血量,稳定血流动力学,改善凝血功能,提高临床治疗效果。
Objective To explore the clinical value of a restrictive fluid resuscitation strategy in the treatment of obstetric hemorrhagic shock patients.Methods A retrospective analysis was conducted on the clinical data of obstetric hemorrhagic shock patients admitted to Bijie Traditional Chinese Medicine Hospital and Bijie Qixingguan District Maternal and Child Health Group from October 2019 to August 2024.Based on the fluid resuscitation strategy,the patients were divided into two groups:the observation group(30 patients,received restrictive fluid resuscitation)and the control group(30 patients,received conventional fluid resuscitation).The bleeding volume,fluid intake,and blood transfusion requirements were compared between the two groups.The observed indicators included:1)Hemodynamic parameters:mean arterial pressure(MAP),hematocrit(HCT),central venous pressure(CVP),and heart rate(HR);2)Coagulation function markers:prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),and fibrinogen(FIB)levels;3)Clinical efficacy evaluation.Results Compared to the control group,the observation group had significantly lower bleeding volume,fluid intake,and blood transfusion requirements(P<0.001).Before treatment,there were no significant differences in hemodynamic parameters(MAP,CVP,HR,HCT)and coagulation function markers(PT,APTT,TT,FIB)between the two groups.After treatment,MAP,CVP,HCT,and FIB levels increased,while HR,PT,APTT,and TT levels decreased in both groups.The observation group showed significantly higher MAP,CVP,HCT,and FIB levels(P<0.05)and lower HR,PT,APTT,and TT levels(P<0.05)compared to the control group.Additionally,the clinical overall treatment efficacy rate was significantly higher in the observation group than in the control group(96.67%vs.80.00%,P<0.05).Conclusion In the treatment of obstetric hemorrhagic shock,the restrictive fluid resuscitation strategy can effectively reduce bleeding volume,stabilize hemodynamics,improve coagulation function,and enhance clinical treatment outcomes.
作者
李曼
肖欢
洪丽华
邱丽霞
LI Man;XIAO Huan;HONG Lihua;QIU Lixia(Bijie Traditional Chinese Medicine Hospitalobstetrical department,Bijie 551700,China;Bijie Traditional Chinese Medicine HospitalOrthopedics and Joint Surgery,Bijie 551700,China;Qixingguan District Traditional Chinese Medicine Maternal and Child Group Hospital,Bijie Cityobstetrical department,Bijie 551700,China;Zhejiang Provincial People's Hospital Bijie Hospitalobstetrical department,Bijie 551700,China)
出处
《中华灾害救援医学》
2025年第4期397-400,共4页
Chinese Journal of Disaster Medicine
基金
2024年度贵州省卫生健康委科学技术基金项目(gzwkj2024-400)。
