不同液体复苏方式在严重多发伤患者早期急救中的应用  

Application of Different Fluid Resuscitation Methods in Early Emergency Treatment of Patients with Severe Multiple Injuries

作　　者：孙晓伟 夏铭远 王曜晖 SUN Xiaowei;XIA Mingyuan;WANG Yaohui(Rongcheng Hospital of Traditional Chinese Medicine,Weihai,Shandong Province,264300 China)

机构地区：[1]荣成市中医院,山东威海264300

出　　处：《系统医学》2024年第8期74-77,81,共5页Systems Medicine

摘　　要：目的总结医院严重多发伤患者早期急救相关资料,分析不同液体复苏方式对急救效果的影响。方法回顾性选取2021年7月—2023年6月荣成市中医院收治的92例严重多发伤患者的临床资料,根据液体复苏方式分为观察组(基于持续监测的容量管理,n=46)与对照组(常规限制性液体复苏,n=46)。比较两组预后结局、心率(Heart Rate,HR)、平均动脉压(Mean Arterial Pressure,MAP)、心排血量(Cardiac Output,CO)、心排血指数(Cardiac Index,CI)、血乳酸(Lactic Acid,Lac)、并发症发生情况。结果观察组机械通气时间为(15.27±3.23)h,短于对照组的(17.85±2.69)h;观察组液体复苏达标时间为(5.27±0.92)h,短于对照组的(6.02±1.04)h,差异有统计学意义(t=4.163、3.663,P均<0.001)。两组HR、MAP指标与并发症发生率比较,差异无统计学意义(P均>0.05)。治疗后,观察组Lac水平低于对照组,CO、CI水平高于对照组,差异有统计学意义(P均<0.05)。结论基于持续监测的容量管理具有较好的液体复苏效果,对严重多发伤患者的心功能及Lac水平有较好的改善作用,能够缩短机械通气时间与液体复苏达标时间。Objective To summarize the early emergency data of patients with severe multiple injuries in hospital,and analyze the influence of different fluid resuscitation methods on emergency results.Methods Clinical data of 92 patients with severe multiple injuries admitted to Rongcheng Hospital of Traditional Chinese Medicine from July 2021 to June 2023 were retrospectively selected,and they were divided into observation group(volume management based on continuous monitoring,n=46)and control group(conventional restricted fluid resuscitation,n=46)according to fluid resuscitation methods.The prognostic outcome,heart rate(HR),mean arterial pressure(MAP),cardiac output(CO)and cardiac index(CI),lactic acid(Lac),and the incidence of complications of the two groups were compared.Results The mechanical ventilation time of the observation group was(15.27±3.23)h,which was shorter than that of the control group(17.85±2.69)h,the standard time of liquid resuscitation in the observation group was(5.27±0.92)h,which was shorter than that in the control group(6.02±1.04)h,and the differences were statistically significant(t=4.163,3.663,both P<0.001).There were no statistically significant differences in HR,MAP index and complication rate between the two groups(all P>0.05).After treatment,Lac level in observation group was lower than control group,CO and CI levels were higher than control group,and the differences were statistically significant(all P<0.05).Conclusion Volume management based on continuous monitoring has a good fluid resuscitation effect,which can improve the cardiac function and Lac level in patients with severe multiple injuries,and shorten the time of mechanical ventilation and the time of liquid resuscitation.

关 键 词：严重多发伤 限制性液体复苏 容量管理 持续监测 

分 类 号：R576[医药卫生—消化系统]