限制性液体复苏联合绿色通道救治严重腹部创伤合并失血性休克的效果分析  

Study on the therapeutic effect of limited fluid resuscitation associated with first-aid fast track in treatment of patients of traumatic hemorrhagic shock with severe abdominal trauma

作　　者：陈发球[1] 陈锡林[2] 林惠文[1] 卢瑞梅[1] 陈荣健[1] 徐志锋[1] 

机构地区：[1]广东省江门市中心医院急诊科,江门529070 [2]中山大学附属第一医院普外科,广州510080

出　　处：《中华普通外科学文献（电子版）》2015年第2期23-25,共3页Chinese Archives of General Surgery(Electronic Edition)

摘　　要：目的探讨限制性液体复苏联合绿色通道对严重腹部创伤合并失血性休克的救治效果。方法回顾性分析2006年5月至2013年5月江门市中心医院急诊收治的128例严重腹部创伤合并失血性休克患者临床资料,对比早期采用低压(A组)和正压(B组)液体复苏联合绿色通道手术治疗的救治效果,并与传统路径正压液体复苏(C组)的救治效果相比较。结果 A组死亡12例(12/64,18.75%),B组死亡12例(12/45,26.67%),C组死亡7例(7/19,36.84%);3组患者病死率比较差异有统计学意义(掊2=6.825,P=0.037)。A组患者的并发症发生率低于B组、C组(掊2=8.974,P=0.011),血浆凝血酶原时间(PT)最短(t=10.619,P=0.000)。结论限制性液体复苏联合绿色通道能降低严重腹部创伤合并失血性休克患者的病死率,提高存活率,并能降低存活患者并发症的发生率。Objective To discuss the clinical effect of limited fluid resuscitation associated with first-aid fast track for severe abdominal trauma and hemorrhagic shock. Methods A retrospective anal-ysis was carried out on the therapeutic effect of one hundred and twenty-eight cases with severe abdomi-nal trauma and hemorrhagic shock, treated with limited fluid resuscitation or adequate fluid resuscitation by different operation paths. Results In limited fluid resuscitation associated with first-aid fast track group, both the mortality and the complication rate of survival patients were significantly lower than those with adequate fluid resuscitation group whether by traditional track or first-aid fast track （ 2=6.825, 8.974, P=0.037, 0.011）. Furthermore, the prothrombin time （PT） was the shortest in the limited fluid resuscitation group （t=10.619, P=0.000）. Conclusion Limited fluid resuscitation associated with first-aid fast track can reduce the mortality of severe abdominal trauma and hemorrhagic shock, improve the survival rate, and reduce postoperative complications of survival patients.

关 键 词：严重腹部创伤 失血性休克 限制性液体复苏 绿色通道 

分 类 号：R459.7[医药卫生—急诊医学]