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目的:观察限制性液体复苏综合救治在失血性休克急诊救治中的效果。方法:选择我院急诊科收治的失血性休克60例,按照随机数字表法分为限制液体复苏组和充分液体复苏组各30例。在给予综合救治的基础上按照液体复苏速度分别给予充分液体复苏及限制液体复苏。比较两组输液量、平均动脉压、不同时间病死率、实验室指标及存活病例并发症发生情况。结果:限制液体复苏组输液量、平均动脉压均显著或非常显著低于充分液体复苏组(P<0.05,P<0.05),急救后1~2h病死率、总病死率均显著低于充分液体复苏组(P<0.05);并发症总发生率20.8%,显著低于充分液体复苏组的40.0%(P<0.05);限制液体复苏组中血红蛋白、血小板计数、血细胞比容均显著高于充分液体复苏组,血浆凝血酶原时间显著短于充分液体复苏组(P<0.05)。结论:限制性液体复苏较充分液体复苏可显著降低失血性休克患者的病死率及并发症发生率。
OBJECTIVE: To observe the effect of comprehensive treatment of restrictive fluid resuscitation in the emergency treatment of hemorrhagic shock. Methods: Sixty hemorrhagic shock patients admitted to our emergency department were divided into three groups according to the random number table: restricted liquid resuscitation group and adequate liquid resuscitation group. On the basis of comprehensive treatment, adequate liquid resuscitation and liquid resuscitation should be given in accordance with the speed of liquid resuscitation. The infusion volume, mean arterial pressure, mortality at different times, laboratory indexes and complications of surviving cases were compared between the two groups. Results: The volume of fluid transfusion and the mean arterial pressure in liquid resuscitation group were all significantly or very significantly lower than those in adequate fluid resuscitation group (P <0.05, P <0.05). The mortality and total morbidity of 1 ~ 2 h after emergency resuscitation were significantly lower than those of adequate fluid resuscitation group (P <0.05). The overall complication rate was 20.8%, which was significantly lower than that of the adequate liquid resuscitation group (40.0%, P <0.05). The levels of hemoglobin, platelet count and hematocrit in the liquid resuscitation group were all significantly higher than those in the resuscitation group Liquid resuscitation group, plasma prothrombin time was significantly shorter than adequate liquid resuscitation group (P <0.05). CONCLUSIONS: Restrictive fluid resuscitation with adequate fluid resuscitation can significantly reduce mortality and complications in patients with hemorrhagic shock.