限制性液体复苏在产科失血性休克治疗中的应用  

Use of Restrictive Fluid Resuscitation in the Treatment of Obstetric Hemorrhagic Shock

作　　者：陈莉莉 CHEN Lili(Xianyou County Maternal and Child Health Hospital Obstetrics and Gynecology Department,Putian 351200,China)

机构地区：[1]仙游县妇幼保健院妇产科,福建莆田351200

出　　处：《中华灾害救援医学》2024年第10期1166-1169,共4页Chinese Journal of Disaster Medicine

摘　　要：目的探讨产科失血性休克治疗中采取限制性液体复苏的临床价值。方法回顾性选取2019年3月至2024年5月仙游县妇幼保健院产科收治的68例失血性休克产妇为研究对象,分为限制性液体复苏(观察组,34例)和常规液体复苏(对照组,34例)。比较出血量、血流动力学和凝血功能相关指标以及临床疗效情况。结果与对照组患者相比,观察组患者的出血量、液体输入量、输血量均较对照组少(P<0.001)。与治疗前相比,两组患者平均动脉压(MAP)、中心静脉压(CVP)、血细胞比容(HCT)水平显著升高(P<0.001),心率(HR)水平降低(P<0.001);且观察组患者MAP、CVP、HCT水平显著高于对照组(P<0.001),HR水平显著低于对照组(P<0.001)。与治疗前相比,两组患者凝血酶原时间(PT)、部分凝血活酶时间(APTT)、凝血酶时间(TT)水平降低(P<0.001),纤维蛋白原(FIB)水平升高(P<0.001);且观察组患者PT、APTT、TT水平显著低于对照组(P<0.001),FIB水平显著高于对照组(P<0.001)。观察组的临床总有效率显著高于对照组(P<0.05)。结论限制性液体复苏可有效改善产科失血性休克患者的血流动力学和凝血功能,减少产妇出血量,临床疗效显著。Objective To investigate the clinical value of restrictive fluid resuscitation in the treatment of obstetric hemorrhagic shock.Methods A retrospective study was conducted on 68 patients with hemorrhagic shock admitted to the obstetrics department of Xianyou County Maternal and Child Health Hospital from March 2019 to May 2024.The patients were divided into a restrictive fluid resuscitation group(observation group,n=34)and a conventional fluid resuscitation group(control group,n=34).Hemorrhage volume,hemodynamic and coagulation function indices,and clinical efficacy were compared between the groups.Results Compared to the control group,patients in the observation group had significantly lower volumes of hemorrhage,fluid input,and blood transfusion(P<0.001).Both groups showed significant increases in mean arterial pressure(MAP),central venous pressure(CVP),and hematocrit(HCT)levels,and a significant decrease in heart rate(HR)levels after treatment(P<0.001).Additionally,the observation group exhibited significantly higher MAP,CVP,and HCT levels,and significantly lower HR levels than the control group(P<0.001).Both groups also showed significant decreases in prothrombin time(PT),partial thromboplastin time(APTT),and thrombin time(TT),and significant increases in fibrinogen(FIB)levels after treatment(P<0.001).The observation group had significantly lower PT,APTT,and TT levels,and significantly higher FIB levels compared to the control group(P<0.001).The overall clinical efficacy rate in the observation group was significantly higher than that in the control group(P<0.05).Conclusion Restrictive fluid resuscitation can effectively improve hemodynamics and coagulation function in patients with obstetric hemorrhagic shock,reduce bleeding volume,and enhance clin ical efficacy.

关 键 词：产科 休克 出血性 复苏术 

分 类 号：R714.463[医药卫生—妇产科学]