限制性液体复苏对多发伤合并颅脑损伤致失血性休克患者的救治效果  

Therapeutic Effect of Restricted Fluid Resuscitation on Patients with Hemorrhagic Shock Caused by Multiple Injuries Combined with Craniocerebral Injury

作　　者：刘东晖[1] LIU Donghui(Xiamen Hospital of Traditional Chinese Medicine,Fujian Province,Xiamen 361009,China)

机构地区：[1]福建省厦门市中医院,福建厦门361009

出　　处：《中国医学创新》2023年第15期141-145,共5页Medical Innovation of China

摘　　要：目的:探讨限制性液体复苏对多发伤合并颅脑损伤致失血性休克患者的救治效果。方法:选择2019年1月-2022年6月厦门市中医院收治的103例多发伤合并颅脑损伤致失血性休克患者,采用随机数字表法分为研究组(n=52)和对照组(n=51)。对照组给予常规液体复苏,研究组给予限制性液体复苏治疗。比较两组患者液体复苏情况、凝血酶原时间、血小板计数、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)水平变化情况、休克恢复情况、并发症发生情况及7 d内死亡率。结果:两组胶体使用量、早期复苏时间比较,差异均无统计学意义(P>0.05),研究组液体输入量较对照组更少(P<0.05)。入院时,两组凝血酶原时间、血小板计数比较差异均无统计学意义(P>0.05);复苏30、60 min,研究组凝血酶原时间均低于对照组,血小板计数均高于对照组(P<0.05)。复苏后120 min,两组NIHSS、APACHEⅡ评分比较,差异均有统计学意义(P<0.05)。入院时,两组IL-6、IL-10及TNF-α比较差异均无统计学意义(P>0.05);复苏后120 min,研究组IL-6、IL-10及TNF-α均低于对照组(P<0.05)。复苏后120 min,研究组休克指数、乳酸水平均低于对照组,乳酸清除率高于对照组(P<0.05)。研究组弥散性血管内凝血、呼吸窘迫综合征、多器官功能障碍综合发生率及7 d内死亡率均显著低于对照组(P<0.05)。结论:限制性液体复苏对多发伤合并颅脑损伤致失血性休克患者效果显著,可有效改善患者神经功能,减少并发症发生率和死亡率。Objective:To study the therapeutic effect of restricted fluid resuscitation on patients with hemorrhagic shock caused by multiple injuries combined with craniocerebral injury.Method:A total of 103 patients with hemorrhagic shock caused by multiple injuries combined with craniocerebral injury admitted to Xiamen Hospital of Traditional Chinese Medicine from January 2019 to June 2022 were selected and divided into study group(n=52)and control group(n=51)by random number table method.The control group was given routine fluid resuscitation,while the study group was given restricted fluid resuscitation.Fluid resuscitation,prothrombin time,platelet count,interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)levels,recovery from shock,incidence of complications and mortality rate within 7 days were compared between the two groups.Result:There were no significant differences in colloid usage and the early resuscitation time between the two groups(P>0.05),the liquid input in the study group was less than that in the control group(P<0.05).At admission,there were no significant differences in prothrombin time and platelet count between the two groups(P>0.05);after resuscitation for 30 and 60 min,the prothrombin time of the study group was lower than that of the control group,and the platelet count was higher than that of the control group(P<0.05).120 minutes after resuscitation,there were significant differences in NIHSS and APACHEⅡscores between the two groups(P<0.05).At admission,there were no significant differences in IL-6,IL-10 and TNF-αbetween the two groups(P>0.05);120 minutes after resuscitation,the IL-6,IL-10 and TNF-αin the study group were lower than those in the control group(P<0.05).120 minutes after resuscitation,the shock index and the lactic acid level of the study group were lower than those of the control group,the lactic acid clearance rate was higher than that of the control group(P<0.05).The incidence disseminated intravascular coagulation,respiratory distress syndrome,multiple or

关 键 词：限制性液体复苏 多发伤合并颅脑损伤 失血性休克 凝血功能 并发症 死亡率 

分 类 号：R651.15[医药卫生—外科学] R605.971[医药卫生—临床医学]