限制性液体复苏在急诊抢救骨盆骨折并失血性休克的临床观察  

Clinical observation on limited fluid resuscitation in the emergency rescue of pelvic fractures and hemorrhagic shock

作　　者：吴燕生[1] 李金雨[1] 李昌[1] 

机构地区：[1]解放军第175医院(厦门大学附属东南医院)急诊科,福建漳州363000

出　　处：《临床军医杂志》2012年第3期614-615,共2页Clinical Journal of Medical Officers

摘　　要：目的探讨限制性液体复苏在急诊抢救骨盆骨折并失血性休克的治疗效果。方法将2009年1月—2011年5月我院收治的51例骨盆骨折合并失血性休克患者根据早期复苏方法分为限制性复苏组(27例)和常规复苏组(24例),通过损伤严重度评分(ISS)、早期复苏输液量、复苏时间等指标进行量化分析和疗效评估。结果限制性复苏组:ISS评分30.72,复苏输液量2 089 ml,复苏时间102.72 min,复苏后血红蛋白98.36 g/L;常规复苏组:ISS评分30.90,复苏输液量2 965 ml,复苏时间246 min,复苏后血红蛋白79.90 g/L。两组ISS评分差异无统计学意义(P>0.05),复苏输液量、复苏时间、复苏后血红蛋白差异均有统计学意义(P<0.05)。结论限制性液体复苏在急诊抢救骨盆骨折合并失血性休克能使输液量更少,控制出血更好,复苏效果更显著。Objective To analyze the therapeutic efficacy of limited fluid resuscitation in the emergency rescue of pelvic fractures and hemorrhagic shock. Methods Fifty one patients with pelvic fracture and hemorrhagic shock in our hospital form January 2009 to May 2011 were divided into limited recovery group （27 cases） and conventional resuscitation group （24 cases） according to the early recovery methods, quantitative analyzed and evaluated the therapeutic efficacy through the injury severity score （ISS）, fluid volume early recovery, recovery time and other indicators. Results Limited resuscitation group ： ISS score was 30.72, the fluid volume of resuscitation was 2 089ml, recovery time was 102.72 min, hemoglobin after resuscitation was 98.36g/L. Conventional cesosoitation group： ISS score was 30.90, the fluid volume of resuscitation was 2 965ml, recovery time was 246 min, hemoglobin after resuscitation was 79.90g/L. Two .groups＇ ISS score showed no significant difference （ P 〉0. 05 ）, the differences of fluid volume of resuscitation, recovery time and hemoglobin after resuscitation showed statistical significance （ P 〈 0.05 ）. Conclusion Limited fluid resuscitation in the emergency rescue of pelvic fractures with hemorrhagic shock can make less fluid volume, better coutrol of bleeding, the recovery effect is more significant.

关 键 词：限制性液体复苏 骨盆骨折 失血性休克 

分 类 号：R605.971[医药卫生—急诊医学]