院前急救过程中两种液体复苏策略对未控制出血的创伤失血性休克患者凝血功能的影响  

Effects of two fluid resuscitation strategies in pre-hospital emergency treatment on coagulation in patients with uncontrolled bleeding in traumatic hemorrhagic shock

作　　者：朱春华 王岗 季勇 ZHU Chun-hua;WANG Gang;JI Yong(Department of Critical Care,The People′s Hospital of Tongzhou District,Nantong City,Nantong 226300,China)

机构地区：[1]南通市通州区人民医院重症医学科,江苏南通226300

出　　处：《吉林医学》2021年第5期1080-1082,共3页Jilin Medical Journal

摘　　要：目的:比较院前急救过程中两种不同的液体复苏策略对未控制出血的创伤失血性休克患者凝血功能的影响。方法:对院前急救的62例未控制出血的创伤失血性休克的患者,按随机数字法分为观察组(n=32)与对照组(n=30),对照组采用传统的液体复苏策略,观察组采用限制性液体(LFR)复苏策略。比较两组患者至急诊时活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT),纤维蛋白原(Fbg)、血小板(PLT)水平。结果:与对照组比较,观察组PLT、Fbg水平较高,差异有统计学意义(P<0.05);PT、APTT、TT较短,但差异无统计学意义(P>0.05)。结论:LFR策略对院前急救未控制出血的创伤失血性休克患者的凝血功能干扰较少,可能对该类患者的进一步成功复苏有益。Objective To evaluate the effects of two different fluid resuscitation strategies in pre-hospital emergency treatment on coagulation in patients with uncontrolled bleeding in traumatic hemorrhagic shock.Method 62 patients with traumatic hemorrhagic shock without controlled bleeding in pre-hospital emergency were divided into the observation group(n=32)and the control group(n=30)according to the random number method.The control group adopted the traditional fluid resuscitation strategy,while the observation group adopted the restricted fluid resuscitation strategy.The activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen(Fbg)and platelets(PLT)were compared between the two groups.Results Compared with the control group,the levels of PLT and Fbg in the observation group were higher(P<0.05).PT,APTT,TT were lower,but the difference was not statistically significant(P>0.05).Conclusion Restricted fluid resuscitation strategy has less interference with the coagulation function of traumatic hemorrhagic shock patients with uncontrolled bleeding in pre-hospital emergency,and may be beneficial to the further successful resuscitation of such patients.

关 键 词：创伤 出血性休克 液体复苏 院前急救 凝血功能 

分 类 号：R641[医药卫生—外科学] R605.971[医药卫生—临床医学]