限制性液体复苏联合损伤控制手术在严重多发伤伴低血容量性休克急诊救治中的意义  

Limited fluids resuscitation(LFR) and damage control surgery(DCS) in the emergency treatment of severe multiple injuries with hemorrhagic shock

作　　者：李力卓[1,2] 何松柏[2] 

机构地区：[1]首都医科大学宣武医院急诊科,北京100053 [2]中国医科大学附属盛京医院急诊科,辽宁沈阳110004

出　　处：《大连医科大学学报》2016年第4期344-347,共4页Journal of Dalian Medical University

基　　金：辽宁省科学技术计划项目(辽宁省自然科学基金计划)(2013010083-401);沈阳市科学技术计划项目(F13-220-9-53)

摘　　要：目的探讨和总结限制性液体复苏联合损伤控制手术在严重多发伤低血容量性休克急诊救治中的意义。方法对2012年3月至2015年3月中国医科大学附属盛京医院收治的51例严重多发伤伴低血容量性休克患者采取限制性液体复苏联合损伤控制手术救治(实验组),并与2003年3月至2012年3月收治的50例采取限制性液体复苏联合常规手术方法救治的严重多发伤伴低血容量性休克患者(对照组1)、44例充分液体复苏联合损伤控制性手术方法救治的严重多发伤伴低血容量性休克患者(对照组2)以及46例充分液体复苏和常规手术方法救治的严重多发伤伴低血容量性休克患者(对照组3)进行成功率比较。结果实验组抢救成功34例,成功率66.7%;死亡17例,死亡率33.3%。对照组1抢救成功24例,成功率48.0%;死亡26例,死亡率52.0%。对照组2抢救成功21例,成功率47.7%;死亡23例,死亡率52.3%。对照组3抢救成功16例,成功率34.8%;死亡30例,死亡率65.2%。实验组与对照组3比较,成功率和死亡率差异均有显著性意义(P<0.05),与其他对照组比较差异无显著性意义(P>0.05)。各对照组间成功率和死亡率比较,差异均无显著性意义(P>0.05)。结论在严重多发伤伴低血容量性休克抢救治疗中,限制性液体复苏联合损伤控制性手术具有至关重要作用。Objective To discuss the application of limited fluids resuscitiation （LFR）and Damage control surgery （DCS） in the emergency treatment of severe multiple injuries with hemorrhagic shock. Methods Retrospective analysis of 51 patients of severe multiple injuries with hemorrhagic shock, who were treated by LFR and DCS from March 2012 to March 2015（experimental group）, was performed and compared with 50 patients of severe multiple injuries with hemorrhagic shock treated by LFR and Definitive operation （DO） from March 2003 to March 2012 （control group 1）; 44 patients of severe multiple injuries with hemorrhagic shock treated by Routine fluids resuscitiation （RFR） and DCS from March 2003 to March 2012 （control group 2） and 46 patients of severe multiple injuries with hemorrhagic shock treated by RFR and DO from March 2003 to March 2012 （control group 3）. Results The treatment success rate and mortality rate were 66.7% and 33.3%, respectively in experimental group, 48% and 52% in control group 1, 47.7% and 52.3% in control group 2, 34.8% and 65.2% in control group 3. There was significant difference between the experimental group and control group 3 （P〈0.05）. There were no significant differences between the experimental group and other two control groups, as well as within control groups （P〉0.05）. Conclusion LFR and DCS have a significant effect on severe multiple injuries with hemorrhagic shock in the emergency treatment.

关 键 词：限制性液体复苏 损伤控制手术 严重多发伤 低血容量性休克 急诊救治 

分 类 号：R459.7[医药卫生—急诊医学]