限制性液体复苏与常规液体复苏在创伤失血性休克患者中的应用效果比较  

Comparison of application effects of limited fluid resuscitation and conventional fluid resuscitation in patients with traumatic hemorrhagic shock

作　　者：占强海 邵双 徐鹏安 ZHAN Qianghai;SHAO Shuang;XU Pengan(Intensive Care Unit of Yugan County People’s Hospital,Shangrao 335100 Jiangxi,China)

机构地区：[1]余干县人民医院重症医学科,江西上饶335100

出　　处：《中国民康医学》2025年第5期128-131,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较限制性液体复苏与常规液体复苏在创伤失血性休克患者中的应用效果。方法:选取2023年6月至2024年6月该院收治的100例创伤失血性休克的患者进行前瞻性研究,按照随机数字表法将其分为研究组(n=50)和对照组(n=50)。对照组采用常规液体复苏,研究组采用限制性液体复苏,比较两组复苏前及复苏3 h后凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT)]、血气分析指标[pH值、动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、血清乳酸]、C反应蛋白(CRP)水平,以及并发症发生率。结果:复苏3 h后,两组APTT、TT、PT均长于治疗前,且研究组长于对照组,差异有统计学意义(P<0.05);两组pH值、PaO_(2)水平均高于治疗前,且研究组高于对照组,两组PaCO_(2)、血清乳酸水平均低于复苏前,且研究组低于对照组,差异有统计学意义(P<0.05);两组CRP水平均低于复苏前,且研究组低于对照组,差异有统计学意义(P<0.05);研究组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:限制性液体复苏治疗创伤失血性休克患者可改善凝血功能指标、血气分析指标水平,以及降低CRP水平与并发症发生率的效果优于常规液体复苏。Objective:To compare effects of limited fluid resuscitation and conventional fluid resuscitation in patients with traumatic hemorrhagic shock.Methods:A prospective study was conducted on 100 patients with traumatic hemorrhagic shock admitted to this hospital from June 2023 to June 2024.According to the random number table method,they were divided into study group(n=50) and control group(n=50).The control group was treated with conventional fluid resuscitation,while the study group was treated with limited fluid resuscitation.The levels of coagulation function indexes [activated partial thromboplastin time(APTT),thrombin time(TT),prothrombin time(PT)],blood gas analysis indexes [pH value,arterial partial pressure of carbon dioxide(PaCO_(2)),arterial partial pressure of oxygen(PaO_(2)),serum lactic acid],and C-reactive protein(CRP) before resuscitation and 3 h after resuscitation,and the incidence of complications were compared between the two groups.Results:After 3h of resuscitation,the levels of APTT,TT and PT in the two groups were longer than those before treatment,those in the study group were longer than those in the control group,and the differences were statistically significant(P<0.05).After 3 h of resuscitation,the pH value and the PaO_(2) levels of the two groups were higher than those before treatment,and those in the study group were higher than those in the control group;the levels of PaCO_(2) and serum lactic acid in the two groups were lower than those before resuscitation,and those in the study group were lower than those in the control group;and the differences were statistically significant(P<0.05).After 3 h of resuscitation,the CRP levels of the two groups were lower than those before resuscitation,that in the study group was lower than that in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusions:Limited fl

关 键 词：限制性液体复苏 创伤失血性休克 凝血功能 血气分析指标 并发症 

分 类 号：R605.971[医药卫生—急诊医学]