两种不同液体复苏方法对创伤失血性休克患者血流动力学和心肌损害指标及预后的影响  

Effects of two fluid resuscitation methods on hemodynamic indicators,myocardial damage indicators and prognosis in patients with traumatic hemorrhagic shock

作　　者：谭清实[1] 付强 马武剑 吴敬芳[2] 王勇 贾代良[1] 李京玉 TAN Qingshi;FU Qiang;MA Wujian;WU Jingfang;WANG Yong;JIA Dailiang;LI Jingyu(Department of Emergency Surgery,The Affiliated Hospital of Jining Medical College,Jining 272000,Shandong,China;Department of Paediatrics,The Affiliated Hospital of Jining Medical College,Jining 272000,Shandong,China)

机构地区：[1]济宁医学院附属医院急诊外科,山东济宁272000 [2]济宁医学院附属医院儿科,山东济宁272000

出　　处：《西部医学》2024年第12期1773-1776,共4页Medical Journal of West China

基　　金：山东省中医药科技项目(2021Q086)。

摘　　要：目的 研究两种不同液体复苏方法对创伤性失血休克(THS)患者的血流动力学、心肌损伤及预后的影响。方法 选取2018年2月—2023年2月我院收治的120例THS患者,按简单随机分组法分为限制组和对照组,每组60例。对照组实施常规液体复苏,限制组实施限制性液体复苏(LFR)治疗,比较两组患者血流动力学指标、心肌损害指标及预后。结果 复苏后,限制组心排血量(CO)、心排血指数(CI)、平均动脉压(MAP)均高于对照组(P<0.05);复苏后,限制组心肌肌钙蛋白T(cTnT)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)水平均低于对照组(P<0.05);复苏后,限制组并发症发生率低于对照组(P<0.05)。结论 创伤失血性休克相比常规液体复苏,LFR能够更明显改善患者血流动力学,减轻心肌损害,降低并发症发生。Objective To investigate the effects of two fluid resuscitation methods on hemodynamics,myocardial injury and prognosis in patients with traumatic hemorrhagic shock(THS).Methods A total of 120 patients with THS admitted to the hospital from February 2018 to February 2023 were selected,and randomly divided into the limited group and the control group,with 60 patients in each group.The control group received conventional fluid resuscitation,while the limited group received limited fluid resuscitation(LFR).The hemodynamic indicators,myocardial damage indicators,and prognosis of the two groups were compared.Results After resuscitation,cardiac output(CO),cardiac index(CI)and mean arterial pressure(MAP)in the limited group were higher than those in the control group(P<0.05).After resuscitation,the levels of cardiac troponin T(cTnT),creatine kinase(CK)and creatine kinase isozyme(CK-MB)in the limited group were lower than those in the control group(P<0.05).After resuscitation,the incidence of complications in the limited group was lower than that in the control group(P<0.05).Conclusion Compared with conventional fluid resuscitation,LFR can significantly improve the patients'hemodynamics,alleviate myocardial damage,and reduce the occurrence of complications.

关 键 词：创伤失血性休克 液体复苏 血液动力学 心肌损伤 预后 

分 类 号：R605.97[医药卫生—急诊医学]