急性低血容量性休克初期复苏液体对预后影响的临床观察  

To observation the influence of different liquid during liuid resuscitation in acute hypovolemic shock

作　　者：汪润民[1] 高萍[2] 陈星海[3] 罗家庆[1] 陈华[1] 张更伟[1] 王娇[1] 

机构地区：[1]518020广东,深圳市人民医院急诊科 [2]北京大学深圳医院儿科 [3]吉林大学第二医院急救医学科

出　　处：《中国急救复苏与灾害医学杂志》2013年第10期873-874,899,共3页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：吉林省自然科学基金项目（201215064）

摘　　要：目的对急性低血容量性休克初期进行限制性液体复苏过程中，观察不同液体对预后的影响。方法深圳市人民医院2012年1月～12月因创伤致低血容量性休克的患者40例，随机分成两组，进行限制性液体复苏，统计手术完成前输注的液体种类及量，分析输注液体与患者乳酸、机械通气时间、病死率、SOFA评分等的差异，进而评价在限制性液体复苏中应用不同复苏液体对预后的影响。结果在40例急性低血容量性休克患者中，单独应用晶体复苏组12例，联合应用晶体胶体复苏组28例，单独应用晶体组较联合应用晶体胶体组病死率明显增高P〈0．05，机械通气时间延长P〈0．05，乳酸水平及SOFA评分明显增高P〈0．01。结论在急性低血容量性休克初期进行限制性液体复苏，晶体胶体联合应用较单独应用晶体可降低患者的病死率，能改善患者预后。objective To observe the influence of different liquid on prognosis of the patients who suffered from acute hypovolemic shock in restrictive fluid resuscitation treatment. Methods We analysis 40 patients during 2012.01-2012.12, who suffered from hypovolemic shock caused by trauma .We record the type and quantity of liquid we infused before surgery completion, analysis the difference between lactic acid, mechanical ventilation time, mortality, SOFA score, and then evaluate the influence of fluid on the prognosis of hypovolemic shock patients in restrictive resuscitation. Results In 40 cases of acute hypovolemic shock patients, simple to use crystal fluid resuscitation group is 12 cases, both use of crystal and colloid resuscitation group is 28 cases. Simple to use crystal group seems to be a significantly higher mortality P 〈 0.05, prolonged mechanical ventilation, P 〈 0.05, lactic acid level and SOFA score significantly higher P 〈 0.01. Conclusion In the acute hypovolemic shock, use crystal and colloid to apply restrictive fluid resuscitation can reduce mortality and improve prognosis of patients.

关 键 词：低血容量性休克 限制性液体复苏 胶体 

分 类 号：R605.971[医药卫生—急诊医学]