中国实用护理杂志
中國實用護理雜誌
중국실용호리잡지
CHINESE JOURNAL OF PRACTICAL NURSING
2014年
13期
45-47
,共3页
限制性液体复苏%休克%出血%胸外伤%护理
限製性液體複囌%休剋%齣血%胸外傷%護理
한제성액체복소%휴극%출혈%흉외상%호리
Restricted fluid resuscitation%Shock%Bleeding%Thoracic trauma%Nursing
目的 探讨早期限制性液体复苏在胸腹部外伤合并创伤性失血性休克中的临床运用.方法 将收治的140例胸腹部外伤合并创伤性失血性休克的患者随机分为2组.常规液体复苏组(对照组)71例,限制性液体复苏组(限制组)69例.对照组进行大量的补液治疗,在止血前早期、快速、足量补液,保证平均动脉压(MAP)维持在(80～90)mm/Hg(1 mmHg=0.133 kPa);限制组对液体进入量和速度进行控制,术前维持平均动脉压(MAP)在(55～65) mm/Hg,止血后足量液体复苏.比较2组患者的平均输液量、一般情况、并发症发生及病死率.结果 对照组平均输液量明显多于限制组,术前血红蛋白(Hb)及红细胞比容(HCT)明显低于限制组,并发症发生率及病死率高于限制组,差异有统计学意义.结论 创伤性休克术前限制性液体复苏能避免过分扰乱机体的代偿机制和内环境,减少并发症的发生率,显著降低病死率,值得在临床推广使用.
目的 探討早期限製性液體複囌在胸腹部外傷閤併創傷性失血性休剋中的臨床運用.方法 將收治的140例胸腹部外傷閤併創傷性失血性休剋的患者隨機分為2組.常規液體複囌組(對照組)71例,限製性液體複囌組(限製組)69例.對照組進行大量的補液治療,在止血前早期、快速、足量補液,保證平均動脈壓(MAP)維持在(80～90)mm/Hg(1 mmHg=0.133 kPa);限製組對液體進入量和速度進行控製,術前維持平均動脈壓(MAP)在(55～65) mm/Hg,止血後足量液體複囌.比較2組患者的平均輸液量、一般情況、併髮癥髮生及病死率.結果 對照組平均輸液量明顯多于限製組,術前血紅蛋白(Hb)及紅細胞比容(HCT)明顯低于限製組,併髮癥髮生率及病死率高于限製組,差異有統計學意義.結論 創傷性休剋術前限製性液體複囌能避免過分擾亂機體的代償機製和內環境,減少併髮癥的髮生率,顯著降低病死率,值得在臨床推廣使用.
목적 탐토조기한제성액체복소재흉복부외상합병창상성실혈성휴극중적림상운용.방법 장수치적140례흉복부외상합병창상성실혈성휴극적환자수궤분위2조.상규액체복소조(대조조)71례,한제성액체복소조(한제조)69례.대조조진행대량적보액치료,재지혈전조기、쾌속、족량보액,보증평균동맥압(MAP)유지재(80～90)mm/Hg(1 mmHg=0.133 kPa);한제조대액체진입량화속도진행공제,술전유지평균동맥압(MAP)재(55～65) mm/Hg,지혈후족량액체복소.비교2조환자적평균수액량、일반정황、병발증발생급병사솔.결과 대조조평균수액량명현다우한제조,술전혈홍단백(Hb)급홍세포비용(HCT)명현저우한제조,병발증발생솔급병사솔고우한제조,차이유통계학의의.결론 창상성휴극술전한제성액체복소능피면과분우란궤체적대상궤제화내배경,감소병발증적발생솔,현저강저병사솔,치득재림상추엄사용.
Objective To discuss about the application of early restricted fluid resuscitation in dealing with thoracic and abdominal trauma combined with hemorrhagic shock.Methods 140 cases of patients with thoracic and abdominal trauma combined with hemorrhagic shock were divided into two groups stochastically,one group was dealt with conventional liquid resuscitation (the control group,71 cases),the other group was treated with limited fluid resuscitation (the limited group,69 cases).The patients of the control group were treated substantial rehydration therapy,the rehydration was carried out quickly and sufficiently in the early before hemostasis,to keep the mean arterial pressure (MAP) at 80～90 mmHg (1 mmHg=0.133 kPa); The amount and velocity of entering liquid of the limited group was under controlled,their MAP was kept at 55～65 mmHg,Adequate fluid resuscitation was carried out after bleeding was stopped.The average amount of infusion,the general situation,the incidences of complications and the death rates of two groups were compared.Results The average amount of infusion in the control group was significantly more than the limited group,the preoperative Hb and HCT of the control group were obviously lower than the limited group,the incidence of complications and the death rate of the control group were higher than the limited group.Conclusions If preoperative restricted fluid resuscitation for traumatic shock was used,the Harassing for Organism's compensatory mechanisms and internal environment could be avoided,the incidence of complications and the death rate will become lower,therefore,this method was worth to be extended in the clinical operation.
