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目的比较高渗盐液体复苏、限制性液体复苏及常规液体复苏在创伤失血性休克中的应用效果。方法 76例创伤失血性休克患者根据治疗方法的不同分为A组(25例)、B组(29例)、C组(22例)三组,分别接受高渗盐液体复苏、限制性液体复苏及常规液体复苏。比较三组死亡率、平均输液量、肾功能、并发症发生率、相关实验室指标的差别。结果三组24 h内死亡率差异无统计学意义(P>0.05),1周内C组死亡率显著高于A组及B组(P<0.05);C组并发症发生率显著高于A组及B组(P<0.05);C组平均输液量显著多于B组及A组(P<0.05);A组、B组血红蛋白(HBG)、血小板(PLT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)显著优于C组(P<0.05);复苏后A组及B组尿素氮(BUN)及肌酐(Scr)显著低于C组(P<0.05);A组与B组复苏后左室射血分数(LVEF)显著优于C组(P<0.05)。结论与常规液体复苏相比,高渗盐液体复苏及限制性液体复苏治疗创伤失血性休克更有利于改善患者临床结局。
Objective To compare the effects of hypertonic saline resuscitation, restrictive fluid resuscitation and conventional fluid resuscitation in traumatic hemorrhagic shock. Methods A total of 76 patients with traumatic hemorrhagic shock were divided into group A (n = 25), group B (n = 29) and group C (n = 22) according to the different treatment methods. Three groups received hypertonic saline resuscitation, And conventional liquid recovery. The differences among the three groups in mortality, average infusion volume, renal function, complication rate and related laboratory indexes were compared. Results There was no significant difference in mortality within 24 hours among the three groups (P> 0.05). The mortality in group C was significantly higher than that in group A and group B in one week (P <0.05). The incidence of complications in group C was significantly higher than that in group A (P <0.05). The average transfusion volume in group C was significantly more than that in group B and group A (P <0.05). The levels of hemoglobin (HBG), platelet (PLT), prothrombin time ). The activated partial thromboplastin time (APTT) was significantly better than that of group C (P <0.05). The levels of BUN and Scr in group A and group B after resuscitation were significantly lower than those in group C (P <0.05). The left ventricular ejection fraction (LVEF) in group A and group B was significantly better than that in group C (P <0.05). Conclusion Compared with conventional liquid resuscitation, hypertonic saline resuscitation and restrictive fluid resuscitation are more effective in improving the clinical outcome of traumatic hemorrhagic shock.