院前低压复苏对严重创伤出血患者肝肾器官功能及凝血功能的影响  

Efficacy of hypotensive resuscitation before admission onliver and kidney organ function and coagulation function in patientswith severe traumatic hemorrhage

作　　者：王建恩 Wang Jian'en

机构地区：[1]中山大学附属第七医院(深圳)急诊与灾难医学中心,广东深圳518107

出　　处：《中医临床研究》2020年第5期118-120,共3页Clinical Journal Of Chinese Medicine

摘　　要：目的:对比严重创伤出血患者院前采用适度低压复苏与常压复苏的效果。方法:纳入我院急诊科收治的严重创伤出血患者共107例作为研究对象,抽签法将所纳入的患者分为常压组53例、低压组54例,其中常压组患者在院前接诊止血前行常压复苏[将平均动脉压(Mean Arterial Pressure,MAP)维持在为80 mm Hg左右],低压组患者行低压复苏(将MAP维持在60 mm Hg左右)。对比两种不同压力液体复苏对患者输液量、输血量、凝血功能及肝肾功能的影响。结果:低压组患者的术前输液量、术中输液量及术中输血量均低于常压组(P<0.05);术后12 h低压组患者的肝肾功能指标门冬氨酸转氨酶(Aspartate Aminotransferase,AST)、丙氨酸转氨酶(Alanine Aminotransferase,ALT)、尿素氮(Blood Urea Nitrogen,BUN)及凝血功能指标部分凝血活酶时间(Activated Partial Thromboplastin Time,APTT)及凝血酶原时间(Prothrombin Time,PT)均低于常压组(P<0.05)。结论:院前低压复苏(MAP=60 mm Hg)可减少严重创伤患者的输液输血量,保护肝肾器官及凝血功能。Objective:To compare the effects of hypotensive resuscitation before admission on liver and kidney organ function and coagulation function in patients with severe traumatic hemorrhage.Methods:107 patients were divided into 53 patients in normal pressure group and 54 patients of low pressure group.The normal pressure group was admitted normal pressure was maintained at about 80 mm Hg.The low-pressure group underwent low-pressure resuscitation(maintaining MAP at about 60 mm Hg).Results:The preoperative,intraoperative,and intraoperative blood transfusion volume in the low-pressure group were lower than those in the normal-pressure group(P﹤0.05).AST,ALT,BUN and APTT and PT in the low-pressure group in 12 hours after surgery were lower than the normal pressure group(P﹤0.05).Conclusion:Pre-hospital low-pressure resuscitation(MAP 60 mm Hg)can reduce the amount of blood transfusion and protect liver and kidney organs and coagulation function in patients with severe trauma.

关 键 词：创伤 出血 液体复苏 器官功能 

分 类 号：R459.7[医药卫生—急诊医学]