Objective:To evaluate the treatment regimen and efficacy for limb fractures combined with traumatic shock(TS).Methods:A total of 88 patients with limb fractures combined with TS,admitted between January 2021 and Decem...Objective:To evaluate the treatment regimen and efficacy for limb fractures combined with traumatic shock(TS).Methods:A total of 88 patients with limb fractures combined with TS,admitted between January 2021 and December 2023,were selected.Patients were divided randomly using a numerical grouping method.The observation group underwent restricted fluid resuscitation combined with comprehensive treatment,while the reference group received conventional fluid resuscitation combined with comprehensive treatment.Recovery time,fracture prognosis,complications,severity of the condition,and post-fracture joint function were compared between the two groups.Results:The observation group showed shorter symptom recovery times,a higher rate of anatomical fracture reduction,and a lower complication rate compared to the reference group(P<0.05).After one week of treatment,the severity score of the condition in the observation group was lower than that of the reference group,and all joint function scores were higher in the observation group(P<0.05).Conclusion:Restricted fluid resuscitation combined with comprehensive treatment for limb fractures with TS can alleviate symptoms,improve fracture prognosis,reduce related complications,decrease the severity of trauma,and enhance joint function.The therapeutic effect is excellent.展开更多
The therapeutic effects of intensive insulin therapy in treatment of traumatic shock combined with multiple organ dysfunction syndrome （MODS） were investigated. A total of 114 patients with traumatic shock combined ...The therapeutic effects of intensive insulin therapy in treatment of traumatic shock combined with multiple organ dysfunction syndrome （MODS） were investigated. A total of 114 patients with traumatic shock combined with MODS were randomly divided into two groups： control group （n=56） treated with conventional therapy, and intensive insulin therapy group （n=58） treated with conventional therapy plus continuous insulin pumping to control the blood glucose level at range of 4.4-6.1 mmol/L. White blood cells （WBC） counts, prothrombin time （PT）, serum creatinine （SCr）, alanine aminotransferase （ALT）, serum albumin and PaO2 were measured before and at the day 1, 3, 5, 7 and 14 after treatment. The incidence of gastrointestinal dysfunction, the incidence of MODS, hospital stay and the mortality were also observed and compared. After intensive insulin therapy, the WBC counts, SCr, ALT and PT were significantly reduced （P0.05）, but the level of serum albumin was significantly increased （P0.05） at the day 3, 5, 7 and 14. In the meantime, the PaO2 was significantly elevated at the day 3, 5 and 7 （P0.01） after intensive insulin therapy. The incidence of gastrointestinal dysfunction, the incidence of MODS, the length of hospital stay and the mortality were markedly decreased （P0.01）. The results suggest early treatment with intensive insulin therapy is effective for traumatic shock combined with MODS and can decrease the length of hospital stay and the mortality.展开更多
Objective： To investigate the effect of preoperative limited fluid resuscitation on the patients with traumatic shock. Methods： Eighty-nine patients with multiple injuries complicating with shock were treated in Cha...Objective： To investigate the effect of preoperative limited fluid resuscitation on the patients with traumatic shock. Methods： Eighty-nine patients with multiple injuries complicating with shock were treated in Changhai Hospital Between January 2002 to October 2005 and were divided into 3 groups according to the preoperative levels of systolic blood pressure （SBP）. SBP of group A and group B were about 70 and 80 mmHg, respectively; and the SBP of group C was over 90 mmHg. Results, （1） There was no significant difference in age, gender, and injury severity score （ISS）, initiated resuscitation time and initiated operation time among the 3 groups. Preoperatively, there was significant difference in the amount of fluid resuscitation and infused erythrocyte suspension among group A, B and C （1687 ± 96 ml, 2096 ± 87 ml, 2976±93 ml, P〈0. 05; and 294±110 ml, 404±113 ml, 798±230 ml, P〈0. 05）. （2） The hemoglobin level in group C （94±45 g/L） was lower than that in group A （110±22 g/L） and group B （103±24 g/L） （P〈0.05）. However, there was no significant difference in the level of hemoglobin between group A and B. （3） There was no significant difference in the incidence of acute renal failure （ARF） among the 3 groups. The incidence of acute respiratory distress syndrome （ARDS） of group C （31.2%） was higher than that of group A （16.7%） and group B （18.2%） （P〈0.05）. The mortality of group C （34.4%） was higher than that of group A （12. 5% ） and group B （12. 1% ） （P〈0.05）. Conclusion： Preoperative limited resuscitation applied on patients with traumatic shock can reduce blood loss, incidence of ARDS and mortality.展开更多
Objective: the effect of emergency intervention on traumatic shock patients and its effect on rescue success. Methods: 100 patients with traumatic shock admitted to our center from January 2020 to June 2021 were analy...Objective: the effect of emergency intervention on traumatic shock patients and its effect on rescue success. Methods: 100 patients with traumatic shock admitted to our center from January 2020 to June 2021 were analyzed retrospectively. According to various nursing interventions, the samples were divided into two groups with 50 cases in each group. The two groups of patients were divided into the control group (routine nursing) and the research group (pre-hospital emergency intervention), and the intervention effects of the two groups were compared. Results: compared with the control group, the research group had shorter consultation and treatment time and higher rescue success rate (P.0.05). The total incidence of asphyxia, intravascular coagulation and organ dysfunction in the study group was 4.00%, significantly lower than that in the control group (16.00% (p.05). Before the operation, there was no difference in scores and scores between the two groups (after the intervention, the scores were lower than those of the control group, while the scores of the research group were higher than those of the control group (P.0.05). The nursing satisfaction of the study group was 96.00% (very satisfactory 72.00%, basic satisfactory 24.00%) significantly higher than that of the control group 84.00% (very satisfactory 54.00%, basic satisfactory 28.00%) (P.0.05). Conclusion: the effect of pre-hospital emergency nursing intervention for traumatic shock patients is significant, which can shorten the consultation time and treatment time, improve the success rate of rescue, reduce the incidence of related complications, improve the prognosis and enhance the satisfaction of nursing service, etc. Therefore, the intervention model is worthy of clinical reference and promotion.展开更多
Objective: to explore the value of operating room rescue care for traumatic shock. Methods: 80 traumatic shock patients in our hospital from January 2019 to June 2020 were divided in two groups. The control group was ...Objective: to explore the value of operating room rescue care for traumatic shock. Methods: 80 traumatic shock patients in our hospital from January 2019 to June 2020 were divided in two groups. The control group was given routine care, and the experimental group implemented the operating room rescue nursing cooperation. The success rate of rescue and complication rate were compared between the two groups. Results: the success rate of rescue and the complication rate was lower than the control group, P <0.05. Conclusion: the effect of traumatic shock patients can improve rescue success rate and reduce complication rate.展开更多
Objective:To analyze the value of emergency rescue nursing intervention in the care of patients with traumatic hemorrhagic shock and its impact on the success rate of rescue efforts.Methods:A total of 80 patients with...Objective:To analyze the value of emergency rescue nursing intervention in the care of patients with traumatic hemorrhagic shock and its impact on the success rate of rescue efforts.Methods:A total of 80 patients with traumatic hemorrhagic shock were selected as samples,with the timeframe from July 2022 to July 2023.The patients were randomly divided into two groups using a random number table method.Group A received emergency rescue nursing,while Group B received routine nursing care.The success rate of rescue,rescue indicators,complication rates,and family satisfaction with nursing care were compared between the two groups.Results:The rescue success rate in Group A was higher than in Group B(P<0.05);the total blood loss in Group A was less,and the rescue time,full transportation time,and hospitalization time were shorter than in Group B(P<0.05);the complication rate of patients with traumatic hemorrhagic shock in Group A was lower than in Group B(P<0.05);the family satisfaction with emergency nursing care in Group A was higher than in Group B(P<0.05).Conclusion:Emergency rescue interventions for patients with traumatic hemorrhagic shock can reduce blood loss,shorten rescue times,and improve the success rate of shock rescue,providing a safe and effective approach.展开更多
Objective: To determine the effects of albumin administration on lung injury and apoptosis in traumatic/hemorrhagic shock (T/HS) rats. Methods: Studies were performed on an in vivo model of spontaneously breathing rat...Objective: To determine the effects of albumin administration on lung injury and apoptosis in traumatic/hemorrhagic shock (T/HS) rats. Methods: Studies were performed on an in vivo model of spontaneously breathing rats with induced T/HS; the rats were subjected to femur fracture, ischemia for 30 min, and reperfusion for 20 min with Ringer's lactate solution (RS) or 5% (w/v) albumin (ALB), and the left lower lobes of the lungs were resected. Results: Albumin administered during reperfusion markedly attenuated injury of the lung and decreased the concentration of lactic acid and the number of in situ TdT-mediated dUTP nick-end labelling (TUNEL)-positive cells. Moreover, immunohistochemistry performed 24 h after reperfusion revealed increases in the level of nuclear factor κB (NF-κB), and phosphorylated p38 mitogen-activated protein kinase (MAPK) in the albumin-untreated group was down-regulated by albumin treatment when compared with the sham rats. Conclusion: Resuscitation with albumin attenuates tissue injury and inhibits T/HS-induced apoptosis in the lung via the p38 MAPK signal transduction pathway that functions to stimulate the activation of NF-κB.展开更多
Objective: to explore the effect of emergency nursing on patients with severe traumatic hemorrhagic shock. Methods: 100 patients with severe traumatic hemorrhagic shock were selected for group nursing, the control gro...Objective: to explore the effect of emergency nursing on patients with severe traumatic hemorrhagic shock. Methods: 100 patients with severe traumatic hemorrhagic shock were selected for group nursing, the control group for routine nursing, and the experimental group for emergency nursing. The clinical data of the two groups were observed. Results: the rescue success rate and nursing satisfaction of the experimental group were higher than those of the control group (P < 0.05), and the incidence of complications, the whole operation time and the stay time in the emergency department were lower than those of the control group (P < 0.05).Conclusion: emergency nursing for patients with severe traumatic shock can effectively improve the success rate of rescue and reduce the incidence of complications.展开更多
Objective. To determine the effect of albumin administration on lung injury in traumatic/hemorrhagic shock （T/HS） rats. Methods： Forty-eight adult Sprague-Dawley rats were divided into three groups randomly （ n =...Objective. To determine the effect of albumin administration on lung injury in traumatic/hemorrhagic shock （T/HS） rats. Methods： Forty-eight adult Sprague-Dawley rats were divided into three groups randomly （ n = 16 in each group） ： Group A, Group B, Group C. In Group A, rats underwent laparotomy without shock. In Group B, rats undergoing T/HS were resuscitated with their blood plus lactated Ringer＇s （twice the volume of shed blood ）. In Group C, rats undergoing T/HS were resuscitated with their shed blood plus additional 3 ml of 5% human albumin. The expression of polymorphonuclear neutrophils CD18/CD11b in jugular vein blood was evaluated. The main lung injury indexes （the activity of myeloperoxidase and lung injury score） were measured. Results： Significant differences of the expression of CD18/11b and the severity degree of lung injury were found between the three groups. （P〈0.05）. The expression of CD18/CD11b and the main lung injury indexes in Group B and Goup C incresed significantly compared with those in Group A （P 〈0.05）. At the same time, the expression of CD18/CD11b and the main lung injury indexes in Group C decreased dramatically, compared with those in Group B （ P 〈0.05 ）. Conclusions ： The infusion of albumin during resuscitation period can protect lungs from injury and decrease the expression of CD18/CD11b in T/HS rats.展开更多
Objective: To elucidate which one of μ, δ and κ opioid receptors is involved in the cardiovascular depression following traumatic hemorrhagic shock. Methods: With traumatic hemorrhagic shock rat models, the cha...Objective: To elucidate which one of μ, δ and κ opioid receptors is involved in the cardiovascular depression following traumatic hemorrhagic shock. Methods: With traumatic hemorrhagic shock rat models, the changes of myocardial and brain μ, δ and κ opioid receptors and cardiovascular functions and their relationship with hemodynamic parameters were observed. The effects of δ and κ opioid receptor antagonists on hemodynamic parameters of traumatic hemorrhagic shock rats were observed. Results: Following traumatic hemorrhagic shock, the number of myocardial and brain δ and κ opioid receptors significantly increased, their affinity did not alter, and the increased number of δ and κ opioid receptors was significantly associated with the decreased hemodynamic parameters. However, μ opioid receptor in heart and brain did not obviously change. δ opioid receptor antagonist ICI174,864 and κ opioid receptor antagonist Nor binaltorphimine (50 μg, Icv) could significantly reverse those decreased hemodynamic parameters. Conclusions: It suggests that opioid receptors, especially δ and κ opioid receptors are closely related to the pathogenesis of traumatic hemorrhagic shock, and they play important roles in the depression of cardiovascular function following traumatic hemorrhagic shock.展开更多
基金2023 Zhenjiang Science and Technology Innovation Fund(Key R&D Program-Social Development)Project“Study on the Role of Early Intervention Triggered by MT Prediction Model in Reducing the Incidence and Mortality of TIC in Patients with Multiple Injuries”(Project No.SH2023088)。
文摘Objective:To evaluate the treatment regimen and efficacy for limb fractures combined with traumatic shock(TS).Methods:A total of 88 patients with limb fractures combined with TS,admitted between January 2021 and December 2023,were selected.Patients were divided randomly using a numerical grouping method.The observation group underwent restricted fluid resuscitation combined with comprehensive treatment,while the reference group received conventional fluid resuscitation combined with comprehensive treatment.Recovery time,fracture prognosis,complications,severity of the condition,and post-fracture joint function were compared between the two groups.Results:The observation group showed shorter symptom recovery times,a higher rate of anatomical fracture reduction,and a lower complication rate compared to the reference group(P<0.05).After one week of treatment,the severity score of the condition in the observation group was lower than that of the reference group,and all joint function scores were higher in the observation group(P<0.05).Conclusion:Restricted fluid resuscitation combined with comprehensive treatment for limb fractures with TS can alleviate symptoms,improve fracture prognosis,reduce related complications,decrease the severity of trauma,and enhance joint function.The therapeutic effect is excellent.
基金supported by a grant from National Natural Sciences Foundation of China (No. 30870951)
文摘The therapeutic effects of intensive insulin therapy in treatment of traumatic shock combined with multiple organ dysfunction syndrome （MODS） were investigated. A total of 114 patients with traumatic shock combined with MODS were randomly divided into two groups： control group （n=56） treated with conventional therapy, and intensive insulin therapy group （n=58） treated with conventional therapy plus continuous insulin pumping to control the blood glucose level at range of 4.4-6.1 mmol/L. White blood cells （WBC） counts, prothrombin time （PT）, serum creatinine （SCr）, alanine aminotransferase （ALT）, serum albumin and PaO2 were measured before and at the day 1, 3, 5, 7 and 14 after treatment. The incidence of gastrointestinal dysfunction, the incidence of MODS, hospital stay and the mortality were also observed and compared. After intensive insulin therapy, the WBC counts, SCr, ALT and PT were significantly reduced （P0.05）, but the level of serum albumin was significantly increased （P0.05） at the day 3, 5, 7 and 14. In the meantime, the PaO2 was significantly elevated at the day 3, 5 and 7 （P0.01） after intensive insulin therapy. The incidence of gastrointestinal dysfunction, the incidence of MODS, the length of hospital stay and the mortality were markedly decreased （P0.01）. The results suggest early treatment with intensive insulin therapy is effective for traumatic shock combined with MODS and can decrease the length of hospital stay and the mortality.
文摘Objective： To investigate the effect of preoperative limited fluid resuscitation on the patients with traumatic shock. Methods： Eighty-nine patients with multiple injuries complicating with shock were treated in Changhai Hospital Between January 2002 to October 2005 and were divided into 3 groups according to the preoperative levels of systolic blood pressure （SBP）. SBP of group A and group B were about 70 and 80 mmHg, respectively; and the SBP of group C was over 90 mmHg. Results, （1） There was no significant difference in age, gender, and injury severity score （ISS）, initiated resuscitation time and initiated operation time among the 3 groups. Preoperatively, there was significant difference in the amount of fluid resuscitation and infused erythrocyte suspension among group A, B and C （1687 ± 96 ml, 2096 ± 87 ml, 2976±93 ml, P〈0. 05; and 294±110 ml, 404±113 ml, 798±230 ml, P〈0. 05）. （2） The hemoglobin level in group C （94±45 g/L） was lower than that in group A （110±22 g/L） and group B （103±24 g/L） （P〈0.05）. However, there was no significant difference in the level of hemoglobin between group A and B. （3） There was no significant difference in the incidence of acute renal failure （ARF） among the 3 groups. The incidence of acute respiratory distress syndrome （ARDS） of group C （31.2%） was higher than that of group A （16.7%） and group B （18.2%） （P〈0.05）. The mortality of group C （34.4%） was higher than that of group A （12. 5% ） and group B （12. 1% ） （P〈0.05）. Conclusion： Preoperative limited resuscitation applied on patients with traumatic shock can reduce blood loss, incidence of ARDS and mortality.
文摘Objective: the effect of emergency intervention on traumatic shock patients and its effect on rescue success. Methods: 100 patients with traumatic shock admitted to our center from January 2020 to June 2021 were analyzed retrospectively. According to various nursing interventions, the samples were divided into two groups with 50 cases in each group. The two groups of patients were divided into the control group (routine nursing) and the research group (pre-hospital emergency intervention), and the intervention effects of the two groups were compared. Results: compared with the control group, the research group had shorter consultation and treatment time and higher rescue success rate (P.0.05). The total incidence of asphyxia, intravascular coagulation and organ dysfunction in the study group was 4.00%, significantly lower than that in the control group (16.00% (p.05). Before the operation, there was no difference in scores and scores between the two groups (after the intervention, the scores were lower than those of the control group, while the scores of the research group were higher than those of the control group (P.0.05). The nursing satisfaction of the study group was 96.00% (very satisfactory 72.00%, basic satisfactory 24.00%) significantly higher than that of the control group 84.00% (very satisfactory 54.00%, basic satisfactory 28.00%) (P.0.05). Conclusion: the effect of pre-hospital emergency nursing intervention for traumatic shock patients is significant, which can shorten the consultation time and treatment time, improve the success rate of rescue, reduce the incidence of related complications, improve the prognosis and enhance the satisfaction of nursing service, etc. Therefore, the intervention model is worthy of clinical reference and promotion.
文摘Objective: to explore the value of operating room rescue care for traumatic shock. Methods: 80 traumatic shock patients in our hospital from January 2019 to June 2020 were divided in two groups. The control group was given routine care, and the experimental group implemented the operating room rescue nursing cooperation. The success rate of rescue and complication rate were compared between the two groups. Results: the success rate of rescue and the complication rate was lower than the control group, P <0.05. Conclusion: the effect of traumatic shock patients can improve rescue success rate and reduce complication rate.
文摘Objective:To analyze the value of emergency rescue nursing intervention in the care of patients with traumatic hemorrhagic shock and its impact on the success rate of rescue efforts.Methods:A total of 80 patients with traumatic hemorrhagic shock were selected as samples,with the timeframe from July 2022 to July 2023.The patients were randomly divided into two groups using a random number table method.Group A received emergency rescue nursing,while Group B received routine nursing care.The success rate of rescue,rescue indicators,complication rates,and family satisfaction with nursing care were compared between the two groups.Results:The rescue success rate in Group A was higher than in Group B(P<0.05);the total blood loss in Group A was less,and the rescue time,full transportation time,and hospitalization time were shorter than in Group B(P<0.05);the complication rate of patients with traumatic hemorrhagic shock in Group A was lower than in Group B(P<0.05);the family satisfaction with emergency nursing care in Group A was higher than in Group B(P<0.05).Conclusion:Emergency rescue interventions for patients with traumatic hemorrhagic shock can reduce blood loss,shorten rescue times,and improve the success rate of shock rescue,providing a safe and effective approach.
基金Project supported by the National Natural Science Foundation of China (No. 30672071) the Traditional Chinese Medicine Foun- dation of Zhejiang Province, China (No. 2004C071)
文摘Objective: To determine the effects of albumin administration on lung injury and apoptosis in traumatic/hemorrhagic shock (T/HS) rats. Methods: Studies were performed on an in vivo model of spontaneously breathing rats with induced T/HS; the rats were subjected to femur fracture, ischemia for 30 min, and reperfusion for 20 min with Ringer's lactate solution (RS) or 5% (w/v) albumin (ALB), and the left lower lobes of the lungs were resected. Results: Albumin administered during reperfusion markedly attenuated injury of the lung and decreased the concentration of lactic acid and the number of in situ TdT-mediated dUTP nick-end labelling (TUNEL)-positive cells. Moreover, immunohistochemistry performed 24 h after reperfusion revealed increases in the level of nuclear factor κB (NF-κB), and phosphorylated p38 mitogen-activated protein kinase (MAPK) in the albumin-untreated group was down-regulated by albumin treatment when compared with the sham rats. Conclusion: Resuscitation with albumin attenuates tissue injury and inhibits T/HS-induced apoptosis in the lung via the p38 MAPK signal transduction pathway that functions to stimulate the activation of NF-κB.
文摘Objective: to explore the effect of emergency nursing on patients with severe traumatic hemorrhagic shock. Methods: 100 patients with severe traumatic hemorrhagic shock were selected for group nursing, the control group for routine nursing, and the experimental group for emergency nursing. The clinical data of the two groups were observed. Results: the rescue success rate and nursing satisfaction of the experimental group were higher than those of the control group (P < 0.05), and the incidence of complications, the whole operation time and the stay time in the emergency department were lower than those of the control group (P < 0.05).Conclusion: emergency nursing for patients with severe traumatic shock can effectively improve the success rate of rescue and reduce the incidence of complications.
文摘Objective. To determine the effect of albumin administration on lung injury in traumatic/hemorrhagic shock （T/HS） rats. Methods： Forty-eight adult Sprague-Dawley rats were divided into three groups randomly （ n = 16 in each group） ： Group A, Group B, Group C. In Group A, rats underwent laparotomy without shock. In Group B, rats undergoing T/HS were resuscitated with their blood plus lactated Ringer＇s （twice the volume of shed blood ）. In Group C, rats undergoing T/HS were resuscitated with their shed blood plus additional 3 ml of 5% human albumin. The expression of polymorphonuclear neutrophils CD18/CD11b in jugular vein blood was evaluated. The main lung injury indexes （the activity of myeloperoxidase and lung injury score） were measured. Results： Significant differences of the expression of CD18/11b and the severity degree of lung injury were found between the three groups. （P〈0.05）. The expression of CD18/CD11b and the main lung injury indexes in Group B and Goup C incresed significantly compared with those in Group A （P 〈0.05）. At the same time, the expression of CD18/CD11b and the main lung injury indexes in Group C decreased dramatically, compared with those in Group B （ P 〈0.05 ）. Conclusions ： The infusion of albumin during resuscitation period can protect lungs from injury and decrease the expression of CD18/CD11b in T/HS rats.
文摘Objective: To elucidate which one of μ, δ and κ opioid receptors is involved in the cardiovascular depression following traumatic hemorrhagic shock. Methods: With traumatic hemorrhagic shock rat models, the changes of myocardial and brain μ, δ and κ opioid receptors and cardiovascular functions and their relationship with hemodynamic parameters were observed. The effects of δ and κ opioid receptor antagonists on hemodynamic parameters of traumatic hemorrhagic shock rats were observed. Results: Following traumatic hemorrhagic shock, the number of myocardial and brain δ and κ opioid receptors significantly increased, their affinity did not alter, and the increased number of δ and κ opioid receptors was significantly associated with the decreased hemodynamic parameters. However, μ opioid receptor in heart and brain did not obviously change. δ opioid receptor antagonist ICI174,864 and κ opioid receptor antagonist Nor binaltorphimine (50 μg, Icv) could significantly reverse those decreased hemodynamic parameters. Conclusions: It suggests that opioid receptors, especially δ and κ opioid receptors are closely related to the pathogenesis of traumatic hemorrhagic shock, and they play important roles in the depression of cardiovascular function following traumatic hemorrhagic shock.
