液体复苏联合气压治疗在抗休克早期治疗中的效果  

Effect of fluid resuscitation combined with air pressure therapy in the early stage of shock resistance

作　　者：郑浪宁 梁飘玲 叶丹萍 

机构地区：[1]恩平市人民医院ICU科,广东529400

出　　处：《齐齐哈尔医学院学报》2017年第18期2128-2130,共3页Journal of Qiqihar Medical University

摘　　要：目的探讨气压治疗配合液体复苏在抗休克早期治疗中的效果。方法选择2014年1月至2016年1月恩平市人民医院ICU科收治的54例失血性休克患者作为研究对象,对其临床资料进行回顾性分析,根据其治疗方式的不同将其分为对照组(23例)和观察组(31例),其中对照组患者应用常规液体复苏治疗,观察组患者应用容许性低血压策略的液体复苏。测量、记录并比较两组患者的救治情况及实验室相关指标恢复情况。结果事故现场,两组患者Pt、PT、APTT、Hb和BE等实验室相关指标比较,差异有统计学意义(P>0.05);手术前,观察组患者者Pt、Hb和BE等指标显著高于对照组患者,PT、APTT指标显著低于对照组患者,差异有统计学意义(P<0.05)。入院前,对照组患者输液量(835±540)ml,显著高于观察组患者输液量(236±217)ml,差异无统计学意义(t=5.610,P<0.001);手术前,对照组患者输液量(1910±1335)ml,显著高于观察组患者输液量(332±316)ml,差异有统计学意义(t=6.356,P<0.001)。对照组患者病死率26.1%(6/23),高于观察组患者病死率12.9%(4/31),差异无统计学意义(χ~2=0.773,P=0.379)。结论短期允许的容许性低血压液体复苏方案对于伤前情况较好、低血压持续时间较短以及伤情较为单纯的失血性休克患者而言能明显避免早期积极复苏带来的不良反应,降低病死率,减少并发症发生,改善预后。Objective To investigate the effect of air pressure and fluid resuscitation in the early stage of shock resistance. Methods 54 cases of lost hemorrhagic shock patients accepted treatment in our hospital were selected as the object of study; the clinical data were retrospectively analyzed. According to the treatment modality,they were divided into the control group（ 23 cases） and observed group（ 31 cases）. Patients in the control group were treated with conventional fluid resuscitation,the observed group of patients were treated withpermissive hypotension fluid resuscitation. The therapeutic effect of the two groups were compared. Results There were no significant differences in Pt,PT,APTT,Hb and BE between the two groups in the accident scene（ P〉0.05）; Before admission,the infusion volume of the control group（ 835 ＋ 540） ml was significantly higher than that of the observation group（ 236±217） ml,the difference was not statistically significant（ t = 5.610,P〈0.001）; Before operation,the infusion volume of the control group（ 1910± 1335） ml was significantly higher than that of the observation group（ 332 ± 316） ml,the difference was statistically significant（ t = 6. 356,P〈0. 001）.Patients in the control group（ 6/23）,the mortality rate was 26. 1% higher than the mortality rate of the observation group 12.9%（ 4/31）,the difference was not statistically significant（ χ~2= 0. 773,P = 0. 379）.Conclusions For patients with hemorrhagic shock,good conditions,shorter duration of low blood pressure,and more simple injury,the short term allowed permissive hypotensive fluid resuscitation can obviously avoid the adverse reactions caused by early positive resuscitation,reduce the mortality,reduce the complications and improve the prognosis.

关 键 词：抗休克治疗 液体复苏 容许性低血压 

分 类 号：R657.3[医药卫生—外科学]