不同液体复苏模式对重症胸部创伤合并创伤失血性休克患者预后的影响  

Effect of different fluid resuscitation modes on the prognosis of patients with severe thoracic trauma complicated with hemorrhagic traumatic shock

作　　者：王波[1] 江海[1] 邓毛[1] 彭美红[2] 魏远福[1] 

机构地区：[1]湖北医药学院附属人民医院心胸血管外科,十堰442000 [2]湖北医药学院附属人民医院肛肠外科

出　　处：《中华实验外科杂志》2016年第8期1941-1943,共3页Chinese Journal of Experimental Surgery

摘　　要：目的观察不同液体复苏模式对重症胸部创伤合并创伤失血性休克（HTS）患者预后的影响。方法选取在我院进行重症胸部创伤合并HTS治疗的患者72例，按照随机数字表法分为观察组和对照组各36例，观察组行限制性液体复苏模式治疗，对照组行常规液体复苏模式治疗。比较两组患者治疗后胶体液量、平均输液量、复苏起始时间、急性肾功能衰竭（ARF）、急性呼吸窘迫综合征（ARDS）及弥散性血管内凝血（DIC）、脓毒症等并发症发生率及复苏治愈率、死亡率。结果观察组复苏起始时间为（16．01±6．03）min、平均输液量为（2071．32＋328．51）ml均明显低于对照组，且差异有统计学意义（t=2．129、8．780，P〈0．05）。观察组胶体液量[（836．10±310．59）m1]高于对照组，差异有统计学意义（t=2．018，P〈0．05）。治疗后观察组ARF（13．89％）、ARDS（11．11％）、DIC（11．11％）、脓毒症（16．67％）、死亡发生率（11．11％）均明显低于对照组（x2=5．791、5．143、5．143、7．387、6．237，P〈0．05），而复苏治愈率前者（88．89％）明显高于后者（X2=6．237，P〈0．05）。结论重症胸部创伤合并HTS采用限制性液体复苏模式治疗复苏治愈率高，还能够降低ARDS、ARF、DIC及脓毒症等并发症发生率及死亡率，对预后改善作用显著。Objective ：To observe the effect of different fluid resuscitation modes on the prognosis of patients with severe thoracic trauma complicated with hemorrhagic traumatic shock （HTS）. Methods Seventy - two cases of severe thoracic trauma complicated with HTS treated in our hospital from March 2014 to December 2015 were selected, who were divided into observation group and control group according to the random digital table method, with 36 cases in each group. The observation group was treated with limit- ed fluid resuscitation model, and the control group with conventional fluid resuscitation model. The colloid fluid volume, infusion volume, start time of resuscitation, occurrence rate of complications such as acute renal failure （ARF）, acute respiratory distress syndrome （ARDS）, diffuse intravascular coagulation [ dis- seminated intravascular coagulation （DIC） ] and sepsis, and curative rate of recovery and mortality rate were compared between the two groups after treatment. Results The start time of resuscitation [ （ 16. 01 -± 6. 03 ） min ] was significantly shorter, and average volume of infusion [ （2 071.32 ± 328.51 ） ml ] was sig- nificantly less in the observation group than those in the control group （ t = 2. 129, 8. 780, P 〈 0.05 ）. The colloidal liquid volume in the observation group [ （836. 10 ± 310. 59） ml] was significantly greater than that in the control group （ t = 2. 018, P 〈 0. 05 ）. The occurrence rate of AFR （ 13.89% ）, ARDS （11.11%）, DIC （ 11.11% ） and sepsis （ 16. 67% ）, and mortality rate （ 11.11% ） in the observation group were significantly lower than those in the control group （X2 = 5. 791, 5. 143, 7. 387, 6. 237, P 〈 0.05 ）, while the curative rate of resuscitation in the former （88.89%） was obviously higher than that in the latter （X2 = 6. 237,P 〈 0. 05）. Conclusion The curative rate of resuscitation of limited fluid resuscita- tion model on patients with severe thoracic trauma complicated with HTS is high, wh

关 键 词：限制性液体复苏 重症胸部创伤 创伤失血性休克 预后 

分 类 号：R605.971[医药卫生—急诊医学]