体温管理联合限制性液体复苏对多发伤伴失血性休克患者低体温及应激反应的影响  

Effects of temperature management combined with limited fluid resuscitation on hypothermia and stress response in patients with multiple injury and hemorrhagic shock

作　　者：王旭 魏武运 WANG Xu;WEI Wuyun(the First People's Hospital of Xianyang,Xianyang 712000;Xi'an Sanqiao Jingcheng Hospital,Xi'an 710086,China)

机构地区：[1]咸阳市第一人民医院,陕西咸阳712000 [2]西安三桥精诚医院,陕西西安710086

出　　处：《临床医学研究与实践》2024年第26期66-69,共4页Clinical Research and Practice

摘　　要：目的探究体温管理联合限制性液体复苏对多发伤伴失血性休克患者低体温及应激反应的影响。方法选择2020年1月至2022年10月收治的80例多发伤伴失血性休克患者为研究对象,以随机数字表法将其分为对照组和观察组,各40例。对照组接受常规对症管理+限制性液体复苏干预,观察组在对照组基础上加施体温管理。比较两组的干预效果。结果观察组的躁动、寒战、低体温发生率均低于对照组,差异具有统计学意义(P<0.05)。苏醒后,观察组的促肾上腺皮质激素(ACTH)、促肾上腺皮质激素释放激素(CRH)、皮质醇(Cor)、去甲肾上腺素(NE)水平均低于对照组,差异具有统计学意义(P<0.05)。苏醒后,观察组的平均动脉压(MAP)、心输出量(CO)、心脏指数(CI)高于对照组,每搏量变异度(SVV)低于对照组,差异具有统计学意义(P<0.05)。结论体温管理联合限制性液体复苏用于多发伤伴失血性休克患者复苏干预中,可降低低体温及相关不良事件发生率,改善血流动力学参数,缓解机体应激反应,值得推广。Objective To explore the effects of temperature management combined with limited fluid resuscitation on hypothermia and stress response in patients with multiple injury and hemorrhagic shock.Methods A total of 80 patients with multiple injury and hemorrhagic shock admitted from January 2020 to October 2022 were selected as the research objects.The patients were divided into control group and observation group by random number table method,with 40 cases in each group.The control group received routine symptomatic management+limited fluid resuscitation intervention,and the observation group received temperature management on the basis of the control group.The intervention effects of the two groups were compared.Results The incidences of restlessness,chills and hypothermia in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After awakening,the levels of adrenocorticotropic hormone(ACTH),corticotropin-releasing hormone(CRH),cortisol(Cor)and norepinephrine(NE)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After awakening,the mean arterial pressure(MAP),cardiac output(CO)and cardiac index(CI)of the observation group were higher than those of the control group,the stroke volume variation(SVV)was lower than that of the control group,and the differences were statistically significant(P<0.05).Conclusion Temperature management combined with limited fluid resuscitation for resuscitation intervention in patients with multiple injury and hemorrhagic shock can reduce the incidences of hypothermia and related adverse events,improve hemodynamic parameters,and alleviate the body's stress response,which is worthy of promotion.

关 键 词：体温管理 限制性液体复苏 多发伤 失血性休克 血流动力学参数 应激反应 低体温 

分 类 号：R605.97[医药卫生—急诊医学]