限制性液体复苏与常规液体复苏对失血性休克患者临床疗效分析

目的:探讨限制性液体复苏与常规液体复苏对失血性休克患者死亡率、凝血功能及并发症的影响。方法:选取失血性休克患者100例,随机分为限制组(n=55)和常规组(n=45),其中限制组采用限制性液体复苏抗休克,而常规组采用常规液体复苏。比较两组患者输液量及死亡率、血压与检验指标、并发症发生率。结果:与常规组相比,限制组患者输液量较少,死亡率较低,痊愈率较高,差异有统计学意义(P0.05)。与常规组相比,限制组患者平均动脉压、碱剩余明显较低,血红蛋白、血小板、红细胞比容明显较高,凝血酶原时间明显较短,差异有统计学意义(P0.001)。与常规组相比,限制组患者急性呼吸窘迫综合征、多器官功能障碍综合征发生率较低,差异有统计学意义(P0.05)。结论:限制性液体复苏为失血性休克患者赢得更多后续急诊手术止血时间,能降低患者死亡率和并发症如急性呼吸窘迫综合征、多器官功能障碍综合征的发生率。

Influence of Limited Fluid Resuscitation and Conventional Fluid Resuscitation of Patients with Hemorrhagic Shock

ABSTRACT Objective: To explore the influence of limited fluid resuscitation and conventional fluid resuscitation on the case fatali- ty rate, coagulation function and complication of patients with hemorrhagic shock. Methods: 100 patients with hemorrhagic shock from September 2013 to September 2015 in our hospital were randomly divided into limit group (n=55) and conventional group (n=45). Pa- tients in the limit group were treated by limited fluid resuscitation while patients in the conventional group were treated by conventional fluid resuscitation. Transfusion quantity, case fatality rate, blood pressure, test indexes and rate of complications were compared between two groups. Results: Compared to conventional group, patients in the limit group had less transfusion quantity, lower case fatality rate and higher cure rate, and the differences were statistically significant(P<0.05). Compared to conventional group, patients in the limit group had lower mean arterial pressure and buffuer excess, higher hemoglobin, platelet and hematocrit, shorter prothrombin time, and the differences were statistically significant(P<0.001). Compared to conventional group, patients in the limit group had lower rate of acute respiratory distress syndrome and multiple organ dysfunction syndrome, and the differences were statistically significant(P<0.05). Conclusion: The limited fluid resuscitation was beneficial for patients with hemorrhagic shock to win time for emergency operation rescue, which could reduce case fatality rate and the incidence of complications such as acute respiratory distress syndrome and multiple organ dysfunction. It is worthy of clinical promotion.