不同液体复苏在腹部多发伤导致失血性休克救治中的效果对比研究

目的:比较不同液体复苏在腹部多发伤导致的失血性休克救治中的临床效果及安全性.方法:选取2017年7月至2019年12月我院救治的因高处坠落、交通事故等意外事件导致腹部多发伤且失血性休克的患者83例,根据入院时间分为2组,对照组(于2017年7月至2018年7月入院治疗)和研究组(于2018年8月至2019年12月入院治...

A Comparative Study on Different Fluid Resuscitation in the Treatment of Hemorrhagic Shock Caused by Multiple Abdominal Injuries

ABSTRACT Objective: To compare the clinical effect and safety of different fluid resuscitation in the treatment of hemorrhagic shock caused by multiple bdominal injuries. Methods: From July 2017 to December 2019, 83 patients with multiple abdominal injury and hemorrhagic shock due to accidents such as falling from height, accident were selected in our hospital. According to the time of admission were divided into two groups, the control group (admitted from July 2017 to July 2018), and the study group (admitted from August 2018 to December 2019). During the course of treatment, the control group used conventional adequate fluid resuscitation, and the study group used restricted fluid resuscitation. Clinical efficacy, blood acidity and other related indexes were observed and compared between the two groups. Results: The PaO₂ decreased significantly in the two groups after resuscitation (P<0.05), and the decrease trend of PaO₂ in the control group was more obvious in the study group. At 90 min, 120 min PaO₂ in the control group was significantly lower than that in the study group (P<0.05). After resuscitation, PaCO₂ in the two groups showed a trend of first decline and then increase, and PaCO₂ in the control group was significantly higher than that in the study group (P<0.05). From the pre-resuscitation to the post-resuscitation, the pH of the two groups showed a change trend of first descending and then rising, and the pH of the study group the study group was significantly higher than the control group at 90 min and 120 min after resuscitation (P<0.05). Compared with the pre-resuscitation, the PT values increased significantly after resuscitation in the two groups (P<0.05), while the PT values after resuscitation in the study group were were significantly lower than those of the control group at 90 min and 120 min (P<0.05). After resuscitation, the levels of ALT, AST and creatinine in the study group were significantly lower than those in the control group (P<0.05). In the control group, 9 cases (22.50 %) had complications or death, in the study group, 5 cases (11.62 %) had complications without death, and the incidence of adverse prognosis was significantly lower than that in the control group (P<0.05). Conclusion: For patients with multiple abdominal hemorrhagic shock, early restricted fluid resuscitation can effectively restore the patient''s blood volume, have a small effect on blood oxygen carrying capacity, liver and kidney function, and have high safety, which is conducive to recovery of patients'' prognosis.