中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2012年
8期
895-897
,共3页
失血性休克%创伤%液体复苏
失血性休剋%創傷%液體複囌
실혈성휴극%창상%액체복소
Hemorrhagic traumatic shock%Trauma%Fluid resuscitation
目的 探讨不同液体复苏方式对未控制性创伤失血性休克的治疗效果.方法 回顾性分析2006年9月至2010年10月贵阳医学院附属医院急诊创伤外科收治的未控制性创伤失血性休克患者220例,按常规液体复苏(常规组)和限制性液体复苏(限制组)两种复苏方式分组.常规组使收缩压维持在(90～135) mm Hg,限制组使收缩压维持在(70 ～ 90)mm Hg(1 mm Hg=0.133kPa).对两组患者的体温、中心静脉压、输血量、尿量、肾功能、血色素、静脉血渗透压(Osm)、MODS和DIC发生率、诊治费用、病死率进行统计学分析,比较限制性液体复苏与常规液体复苏对失血性休克患者的疗效.结果 采用两种不同复苏方式治疗后,两组患者的体温、中心静脉压、输血量、尿量、肾功能、血色素、Osm、MODS和DIC发生率、诊治费用、病死率比较,限制组优于常规组,差异具有统计学意义(P＜0.05)；而两组肾功能障碍发生率比较,差异无统计学意义(P＞0.05).结论 在出血未控制的情况下,限制性液体复苏可维持重要脏器的血流灌注、降低出血量、降低MODS发生率和病死率.
目的 探討不同液體複囌方式對未控製性創傷失血性休剋的治療效果.方法 迴顧性分析2006年9月至2010年10月貴暘醫學院附屬醫院急診創傷外科收治的未控製性創傷失血性休剋患者220例,按常規液體複囌(常規組)和限製性液體複囌(限製組)兩種複囌方式分組.常規組使收縮壓維持在(90～135) mm Hg,限製組使收縮壓維持在(70 ～ 90)mm Hg(1 mm Hg=0.133kPa).對兩組患者的體溫、中心靜脈壓、輸血量、尿量、腎功能、血色素、靜脈血滲透壓(Osm)、MODS和DIC髮生率、診治費用、病死率進行統計學分析,比較限製性液體複囌與常規液體複囌對失血性休剋患者的療效.結果 採用兩種不同複囌方式治療後,兩組患者的體溫、中心靜脈壓、輸血量、尿量、腎功能、血色素、Osm、MODS和DIC髮生率、診治費用、病死率比較,限製組優于常規組,差異具有統計學意義(P＜0.05)；而兩組腎功能障礙髮生率比較,差異無統計學意義(P＞0.05).結論 在齣血未控製的情況下,限製性液體複囌可維持重要髒器的血流灌註、降低齣血量、降低MODS髮生率和病死率.
목적 탐토불동액체복소방식대미공제성창상실혈성휴극적치료효과.방법 회고성분석2006년9월지2010년10월귀양의학원부속의원급진창상외과수치적미공제성창상실혈성휴극환자220례,안상규액체복소(상규조)화한제성액체복소(한제조)량충복소방식분조.상규조사수축압유지재(90～135) mm Hg,한제조사수축압유지재(70 ～ 90)mm Hg(1 mm Hg=0.133kPa).대량조환자적체온、중심정맥압、수혈량、뇨량、신공능、혈색소、정맥혈삼투압(Osm)、MODS화DIC발생솔、진치비용、병사솔진행통계학분석,비교한제성액체복소여상규액체복소대실혈성휴극환자적료효.결과 채용량충불동복소방식치료후,량조환자적체온、중심정맥압、수혈량、뇨량、신공능、혈색소、Osm、MODS화DIC발생솔、진치비용、병사솔비교,한제조우우상규조,차이구유통계학의의(P＜0.05)；이량조신공능장애발생솔비교,차이무통계학의의(P＞0.05).결론 재출혈미공제적정황하,한제성액체복소가유지중요장기적혈류관주、강저출혈량、강저MODS발생솔화병사솔.
Objective To investigate the effects of different ways of fluid resuscitation on uncontrolled traumatic hemorrhagic shock. Methods The retrospective analysis of data from 220 casualties with uncontrolled hemorrhagic shock admitted from September 2006 to October 2010 was carried out.There were two ways of fluid resuscitation used to treat casualties with hemorrhagic shock,conventional fluid resuscitation (group A) and limited fluid resuscitation (group B).The systolic pressure was maintained at 90 ～ 135 mm Hg in the group A and at 70 ～ 90 mm Hg in the group B.The data of body temperature,central venous pressure,quantity of blood transfused,urine output,renal function,hemoglobin,blood osmotic pressure (Osm) ,MODS and DIC rates,treatment costs and mortality of two groups were statistically analyzed and compared. Results After analyses of above mentioned variables except renal function and comparison made between two groups,the method of limited fluid resuscitation was much superior over conventional fluid resuscitation (P ＜ 0.05 ).There was no noticeable difference in rate of compromised renal function between two groups ( P ＞ 0.05 ). Conclusions In the case of uncontrolled exsanguination,the method of limited fluid resuscitation can maintain blood perfusion of vital organs,reduce the blood loss and decrease the incidence of MODS and mortality.
