国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2010年
14期
1699-1703
,共5页
限制性补液%肺挫伤%失血性休克
限製性補液%肺挫傷%失血性休剋
한제성보액%폐좌상%실혈성휴극
Infusion restriction%Pulmonary contusion%Hemorrhagic shock
目的 观察限制性补液对肺挫伤伴失血性休克病人的治疗效果.方法 将2008年1月-2010年3月共救治肺挫伤伴失血性休克的病人(ISS≥25)78例,随机分为限制组(40人)和常规组(38人).两组患者均因严重低氧血症和失血性休克行机械通气和体液复苏.分别监测凝血功能(PT和APTT)、碱剩余(BE)、血浆乳酸含量、氧分压、氧合指数及胸片变化情况,统计两组肺挫伤伴失血性休克病人的呼吸机通气时间、住ICU时间、急性呼吸窘迫综合症(ARDS)和多器官功能障碍综合征(MODS)发生率、治愈率和死亡率.结果 限制性补液 与常规补液均能明显降低PT、APTT、BE值和血清乳酸含量;而限制组比常规组更能减少病人 胸部进一步渗出,提高患者氧分压、氧合指数,降低呼吸机通气时间、住ICU时间、ARDS和 MODS的发病率及死亡率,增加治疗率(P<0.05).结论 限制性补液能有效改善肺挫伤伴失血性休克病人凝血紊乱,缓解酸中毒,明显比常规组促进肺部修复,提高肺组织氧合能力,提高患者预后和生存率.
目的 觀察限製性補液對肺挫傷伴失血性休剋病人的治療效果.方法 將2008年1月-2010年3月共救治肺挫傷伴失血性休剋的病人(ISS≥25)78例,隨機分為限製組(40人)和常規組(38人).兩組患者均因嚴重低氧血癥和失血性休剋行機械通氣和體液複囌.分彆鑑測凝血功能(PT和APTT)、堿剩餘(BE)、血漿乳痠含量、氧分壓、氧閤指數及胸片變化情況,統計兩組肺挫傷伴失血性休剋病人的呼吸機通氣時間、住ICU時間、急性呼吸窘迫綜閤癥(ARDS)和多器官功能障礙綜閤徵(MODS)髮生率、治愈率和死亡率.結果 限製性補液 與常規補液均能明顯降低PT、APTT、BE值和血清乳痠含量;而限製組比常規組更能減少病人 胸部進一步滲齣,提高患者氧分壓、氧閤指數,降低呼吸機通氣時間、住ICU時間、ARDS和 MODS的髮病率及死亡率,增加治療率(P<0.05).結論 限製性補液能有效改善肺挫傷伴失血性休剋病人凝血紊亂,緩解痠中毒,明顯比常規組促進肺部脩複,提高肺組織氧閤能力,提高患者預後和生存率.
목적 관찰한제성보액대폐좌상반실혈성휴극병인적치료효과.방법 장2008년1월-2010년3월공구치폐좌상반실혈성휴극적병인(ISS≥25)78례,수궤분위한제조(40인)화상규조(38인).량조환자균인엄중저양혈증화실혈성휴극행궤계통기화체액복소.분별감측응혈공능(PT화APTT)、감잉여(BE)、혈장유산함량、양분압、양합지수급흉편변화정황,통계량조폐좌상반실혈성휴극병인적호흡궤통기시간、주ICU시간、급성호흡군박종합증(ARDS)화다기관공능장애종합정(MODS)발생솔、치유솔화사망솔.결과 한제성보액 여상규보액균능명현강저PT、APTT、BE치화혈청유산함량;이한제조비상규조경능감소병인 흉부진일보삼출,제고환자양분압、양합지수,강저호흡궤통기시간、주ICU시간、ARDS화 MODS적발병솔급사망솔,증가치료솔(P<0.05).결론 한제성보액능유효개선폐좌상반실혈성휴극병인응혈문란,완해산중독,명현비상규조촉진폐부수복,제고폐조직양합능력,제고환자예후화생존솔.
Objective To explore the effect of infusion restriction on pulmonary contusion with hemorrhagic shock.Methods Seventy-eight patients (ISS≥25) with pulmonary contusion and hemorrhagic shock who had been hospitalized from January 2008 to March 2010 were included in this study.All the patients required mechanical ventilation and fluid rescue because of severe hypoxia and shock and were randomly divided into conventional group (n = 38) and restriction group (n = 40).FT,APTT,BE,lactic acid content,PO2,PO2/FiO2,and changes in chest radiology were determined; ventilation time,length of ICU stay,the motality,incidence,and curative rate of ARDS or MODS were studied in the two groups.Results FT,APTT,BE,and lactic acid content were lower in both restriction group and convertional group.As compared with conventional group,PO2,PO2/FiO2,and pulmonary inflammatory absorption were elevated (P<0.05),ventilation time and length of ICU stay were shortened,the mortality and incidence of ARDS or MODS were reduced (P<0.05),and the curative rate was increased in restriction group (P<0.05).Conclusions Infusion restriction in the treatment of pulmonary contusion with hemorrhagic shock can effectively improve coagulopathy and relieve acidosis and it markedly promotes pulmonary repair and increases the survival rate and the prognosis.
