中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
3期
12-14
,共3页
创伤和损伤%休克,出血性%限制性液体复苏%积极性液体复苏
創傷和損傷%休剋,齣血性%限製性液體複囌%積極性液體複囌
창상화손상%휴극,출혈성%한제성액체복소%적겁성액체복소
Wound and injuries%Shock,hemorrhagic%Limited fluid resuscitation%Aggressive fluid resuscitation
目的 比较限制性液体复苏与积极性液体复苏救治创伤失血性休克的治疗效果,以提高治愈率.方法 将120例创伤失血性休克患者依据门诊挂号单号码单双数分为限制性液体复苏组(限制组,56例)和积极性液体复苏组(积极组,64例),分别采用不同的液体复苏方法,比较两组术前血乳酸、剩余碱、凝血酶原时间、血红蛋白等指标,并记录术前输液量和死亡情况.结果 限制组术前输液量明显少于积极组[(1 050±212) ml比(2 120± 186) ml],差异有统计学意义(P＜0.01).限制组病死率明显低于积极组[12.50％(7/56)比28.12％(18/64)],差异有统计学意义(P＜0.05).限制组术前血乳酸、剩余碱、凝血酶原时间明显低于积极组[(3.31±0.29) mmol/L比(5.78±0.15) mmol/L、(5.42±1.13) mmol/L比(9.86±1.21) mmol/L、(11.7±1.9)s比(18.1±1.7)s],血红蛋白明显高于积极组[(96±18) g/L比(83±20) g/L],差异均有统计学意义(P＜0.01).结论 在出血未控制的情况下,早期限制性液体复苏在减少输液量的同时,可维持重要脏器的血流灌注,减轻代谢性酸中毒,为后续治疗创造条件.因此,救治创伤失血性休克限制性液体复苏可能优于积极性液体复苏.
目的 比較限製性液體複囌與積極性液體複囌救治創傷失血性休剋的治療效果,以提高治愈率.方法 將120例創傷失血性休剋患者依據門診掛號單號碼單雙數分為限製性液體複囌組(限製組,56例)和積極性液體複囌組(積極組,64例),分彆採用不同的液體複囌方法,比較兩組術前血乳痠、剩餘堿、凝血酶原時間、血紅蛋白等指標,併記錄術前輸液量和死亡情況.結果 限製組術前輸液量明顯少于積極組[(1 050±212) ml比(2 120± 186) ml],差異有統計學意義(P＜0.01).限製組病死率明顯低于積極組[12.50％(7/56)比28.12％(18/64)],差異有統計學意義(P＜0.05).限製組術前血乳痠、剩餘堿、凝血酶原時間明顯低于積極組[(3.31±0.29) mmol/L比(5.78±0.15) mmol/L、(5.42±1.13) mmol/L比(9.86±1.21) mmol/L、(11.7±1.9)s比(18.1±1.7)s],血紅蛋白明顯高于積極組[(96±18) g/L比(83±20) g/L],差異均有統計學意義(P＜0.01).結論 在齣血未控製的情況下,早期限製性液體複囌在減少輸液量的同時,可維持重要髒器的血流灌註,減輕代謝性痠中毒,為後續治療創造條件.因此,救治創傷失血性休剋限製性液體複囌可能優于積極性液體複囌.
목적 비교한제성액체복소여적겁성액체복소구치창상실혈성휴극적치료효과,이제고치유솔.방법 장120례창상실혈성휴극환자의거문진괘호단호마단쌍수분위한제성액체복소조(한제조,56례)화적겁성액체복소조(적겁조,64례),분별채용불동적액체복소방법,비교량조술전혈유산、잉여감、응혈매원시간、혈홍단백등지표,병기록술전수액량화사망정황.결과 한제조술전수액량명현소우적겁조[(1 050±212) ml비(2 120± 186) ml],차이유통계학의의(P＜0.01).한제조병사솔명현저우적겁조[12.50％(7/56)비28.12％(18/64)],차이유통계학의의(P＜0.05).한제조술전혈유산、잉여감、응혈매원시간명현저우적겁조[(3.31±0.29) mmol/L비(5.78±0.15) mmol/L、(5.42±1.13) mmol/L비(9.86±1.21) mmol/L、(11.7±1.9)s비(18.1±1.7)s],혈홍단백명현고우적겁조[(96±18) g/L비(83±20) g/L],차이균유통계학의의(P＜0.01).결론 재출혈미공제적정황하,조기한제성액체복소재감소수액량적동시,가유지중요장기적혈류관주,감경대사성산중독,위후속치료창조조건.인차,구치창상실혈성휴극한제성액체복소가능우우적겁성액체복소.
Objective To compare the effects of limited fluid resuscitation and aggressive fluid resuscitation in treatment of uncontrolled hemorrhagic traumatic shock,and to improve the cure rate.Methods One hundred and twenty patients with hemorrhagic traumatic shock on the basis of outpatient registration number of single and double were divided into limited fluid resuscitation group(limited group,56 cases) and aggressive fluid resuscitation group (positive group,64 cases),respectively.The preoperative blood lactic acid,base excess,prothrombin time,hemoglobin was compared and the preoperative infusion and the number of patients with death was recorded.Results The preoperative infusion in limited group was significantly less than that in positive group [(1 050 ± 212) ml vs.(2 120 ± 186) ml],the difference was statistically significant (P ＜ 0.01).The mortality rate in limited group was significantly lower than that in positive group [12.50％(7/56) vs.28.12％(18/64)],the difference was statistically significant (P＜ 0.05).The preoperative blood lactic acid,base excess,prothrombin time in limited group were significantly lower than those in positive group [(3.31 ± 0.29) mmol/L vs.(5.78 ± 0.15) mmol/L,(5.42 ± 1.13) mmol/L vs.(9.86 ± 1.21) mmol/L,(11.7 ± 1.9) s vs.(18.1 ± 1.7) s],and the hemoglobin in limited group was significantly higher than that in positive group [(96 ± 18) g/L vs.(83 ± 20) g/L],the differences were statistically significant (P ＜0.01).Conclusions If hemorrhage is not controlled,early limited fluid resuscitation can maintain blood perfusion of vital organs,alleviate acidosis,reduce mortality and creat good conditions for advanced treatment.Limited fluid resuscitation is superior to aggressive fluid resuscitation in operative intervention for patients with uncomtrolled hemorrhagic traumatic shock.
