严重多发伤伴创伤失血性休克患者不同液体复苏方式对其临床疗效的影响  

Effect of Different Fluid Resuscitation Methods on Clinical Outcomes in Patients with Severe Multiple Trauma and Traumatic Hemorrhagic Shock

作　　者：陈锋[1] 王莉[1] 王二义 袁素梅[1] 汤海梅[1] 李会芬[1] CHEN Feng;WANG Li;WANG Er-yi;YUAN Su-mei;TANG Hai-mei;LI Hui-fen(Department of Critical Care Medicine,Fenjinting Hospital,Sihong,Jiangsu Province,223900 China)

机构地区：[1]江苏省泗洪县分金亭医院重症医学科

出　　处：《世界复合医学》2019年第10期76-77,80,共3页World Journal of Complex Medicine

摘　　要：目的分析严重多发伤伴创伤失血性休克患者不同液体复苏方式对其临床疗效的影响。方法选取该院2015年2月—2019年2月收治的120例严重多发伤伴创伤失血性休克患者为研究对象,按照随机数字表法分为两组,救治过程中对照组采用传统积极液体复苏方式,观察组则采用限制性液体复苏方式,对比两组患者病死情况、复苏时间、治疗前后APTT(活化部分凝血活酶时间)、PT(凝血酶原时间)、血清乳酸变化情况、急性呼吸窘迫综合征(ARDS)、多器官功能障碍综合征(MODS)等相关并发症发生率情况。结果观察组病死率为3.33%,低于对照组的15.00%,差异有统计学意义(χ^2=4.904,P<0.05);与治疗前相比,两组患者治疗后APTT、PT均有所延长,但观察组短于对照组,差异有统计学意义(t=15.729、13.259,P<0.05);观察组治疗后血清乳酸水平低于对照组,差异有统计学意义(t=10.327,P<0.05);观察组并发症发生率为5.17%,低于对照组的19.61%,差异有统计学意义(χ^2=5.384,P<0.05)。结论严重多发伤伴创伤失血性休克患者采用限制性液体复苏方式治疗的病死率低,利于改善凝血,降低并发症发生率。Objective To analyze the effect of different fluid resuscitation methods on the clinical outcomes of patients with severe multiple trauma and traumatic hemorrhagic shock.Methods A total of 120 patients with severe multiple trauma and traumatic hemorrhagic shock who were admitted to the hospital from February 2015 to February 2019 were enrolled in the study.They were divided into two groups according to the random number table.The control group used traditional active fluid resuscitation.In the observation group,the restrictive fluid resuscitation method was used to compare the mortality,recovery time,APTT(activated partial thromboplastin time),PT(prothrombin time),serum lactate change,acute respiratory distress before and after treatment syndrome(ARDS),multiple organ dysfunction syndrome(MODS)and other related complications.Results The mortality rate of the observation group was 3.33%,which was lower than that of the control group(15.00%).The difference was statistically significant(χ^2=4.904,P<0.05).Compared with before treatment,both groups had prolonged APTT and PT after treatment.However,the observation group was shorter than the control group,and the difference was statistically significant(t=15.729,13.259,P<0.05).The serum lactate level of the observation group was lower than that of the control group after treatment(t=10.327,P<0.05);The incidence of complications in the observation group was 5.17%,which was lower than that in the control group(19.61%).The difference was statistically significant(χ^2=5.384,P<0.05).Conclusion Patients with severe multiple trauma with traumatic hemorrhagic shock treated with limited fluid resuscitation have a low mortality rate,which is beneficial to improve blood coagulation and reduce the incidence of complications.

关 键 词：严重多发伤 创伤失血性休克 限制性液体复苏 积极液体复苏 临床疗效 影响 

分 类 号：R459.7[医药卫生—急诊医学]