限制性液体复苏对创伤性休克患者PT、APTT、Fib、D-D水平及并发症的影响  

Impacts of limited fluid resuscitation on the levels of PT,APTT,Fib and D-D and complications in patients with traumatic shock

作　　者：李园园 郑国营[1] LI Yuanyuan;ZHENG Guoying(Department of Critical Care Medicine,Huadu District People’s Hospital of Guangzhou,Guangdong,Guangzhou 510800,China)

机构地区：[1]广州市花都区人民医院重症医学科,广东广州510800

出　　处：《中国医药科学》2023年第15期162-165,共4页China Medicine And Pharmacy

基　　金：广东省广州市花都区科技计划项目(21-HDWS-047)。

摘　　要：目的探讨对创伤性休克患者给予限制性液体复苏治疗的价值。方法选取2021年1月至2022年1月广州市花都区人民医院重症医学科收治的创伤性休克患者58例,根据随机数表法分两组,每组各29例。对照组行常规液体复苏,观察组行限制性液体复苏。比较治疗前后两组凝血指标、血常规指标及并发症发生情况等。结果治疗前两组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)、D二聚体(D-D)水平比较,差异无统计学意义(P>0.05),治疗后观察组PT、APTT、D-D水平较对照组低,Fib较对照组高,差异有统计学意义(P<0.05),对照组治疗后PT、APTT高于治疗前,差异有统计学意义(P<0.05);治疗前两组血常规指标比较,差异无统计学意义(P>0.05),治疗后观察组血常规指标水平较对照组高,差异有统计学意义(P<0.05);观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论对创伤性休克患者实施限制性液体复苏治疗,血红蛋白水平无明显下降,凝血功能无明显恶化,预后效果更优。Objective To explore the value of restrictive fluid resuscitation treatment for patients with traumatic shock.Methods From January 2021 to January 2022,58 patients with traumatic shock were selected from the Department of Intensive care medicine of Huadu District People's Hospital in Guangzhou,and were divided into two groups according to the random number table,29 patients in each group.The control group received routine liquid resuscitation treatment,while the observation group received restrictive liquid resuscitation treatment.The prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(Fib),D-dimer(D-D),blood routine indicators and complications of the two groups were compared before and after treatment.Result There was no statistically significant difference in PT,APTT,FIB and D-D levels between the two groups before treatment(P>0.05).After treatment,the PT,APTT and D-D levels in the observation group were lower than those in the control group,while FIB levels were higher than those in the control group,with the differences were statistically significant(P<0.05).After treatment,the PT,APTT levels in the control group were higher than those before treatment,with the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in blood routine indicators between the two groups(P>0.05).After treatment,the blood routine indicators in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05);The total incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The implementation of restrictive fluid resuscitation therapy for patients with traumatic shock resulted in no significant decrease in hemoglobin levels,no significant deterioration in coagulation function,and a better prognosis.

关 键 词：创伤性休克 限制性液体复苏 凝血酶原时间 活化部分凝血活酶时间 纤维蛋白原 D二聚体 并发症 

分 类 号：R605.971[医药卫生—急诊医学]