摘要
目的 对比分析不同液体复苏方案治疗急诊创伤失血性休克患者疗效。方法 简单随机选取2021年1月—2023年1月雷州市人民医院急诊外科收入的90例创伤失血性休克患者,按随机数表法分为A、B、C 3组,各30例。A组采用限制性液体复苏方案,B组采用高渗盐液体复苏方案,C组采用常规液体复苏方案。比较3组患者的急诊抢救效果,并观察3组治疗前后凝血功能变化情况,统计各组并发症发生率。结果 3组入院后24 h内和7 d内病死率、抢救成功率相比,差异无统计学意义(P>0.05);治疗前3组凝血功能指标比较,差异无统计学意义(P>0.05),治疗后3组凝血酶原时间(prothrombin time, PT),活化部分凝血活酶时间(activated partial thromboplastin time, APTT)水平均有缩短,其中A组的PT、APTT短于B、C组,差异有统计学意义(P<0.05),B、C组之间差异相比,差异无统计学意义(P>0.05);A、B组并发症发生率分别为3.57%、7.41%,低于C组25.00%,差异有统计学意义(P<0.05)。结论 各种液体复苏方案均能在一定程度上改善患者电解质水平,但相比之下,限制性和高渗盐两种液体复苏的应用优势更突出,在创伤失血性休克患者使用过程中所产生的并发症更少,尤其是限制性液体复苏的凝血功能改善效果最佳,值得作为首选方案。
Objective To compare and analyze the efficacy of different fluid resuscitation protocols in treating emer-gency trauma patients with hemorrhagic shock.Methods A total of 90 patients with traumatic hemorrhagic shock ad-mitted to the Emergency Surgery Department of Leizhou People's Hospital from January 2021 to January 2023 were simply and randomly selected and divided into groups A,B and C according to the random number table method,with 30 cases in each group.Group A was treated with limited fluid resuscitation,group B was treated with hypertonic sa-line fluid resuscitation,and group C was treated with conventional fluid resuscitation.The emergency rescue effects of the three groups were compared,and the changes of coagulation function before and after treatment in the three groups were observed,and the incidence of complications in each group was counted.Results There were no significant differ-ences in the mortality rate and rescue success rate among the three groups within 24 h and 7 d after admission(P>0.05).Before treatment,there was no significant difference in coagulation function among the three groups(P>0.05).The levels of activated partial thromboplastin time(APTT)were shortened,and the PT and APTT of group A were shorter than those of group B and group C,and the differences were statistically significant(P<0.05).The differences between group B and group C were compared.The difference was not statistically significant(P>0.05).The incidence of complications in group A and group B was 3.57%and 7.41%,respectively,which was lower than that in group C(25.00%),and the differences were statistically significant(P<0.05).Conclusion Various fluid resuscitation protocols can improve patients'electrolyte levels to a certain extent.However,in comparison,the advantages of the two fluid re-suscitation applications,restrictive and hypertonic salt,are more prominent,with fewer complications arising from their use in patients with traumatic hemorrhagic shock,especially restrictive fluid resuscitation has the best coagula-tion function improvement effect,which is worthy of being the preferred option.
作者
莫映
吴文钦
莫雄
MO Ying;WU Wenqin;MO Xiong(Department of Emergency Surgery,Leizhou People's Hospital,Leizhou,Guangdong Province,524200 China)
出处
《中外医疗》
2023年第33期95-98,共4页
China & Foreign Medical Treatment
关键词
液体复苏方案
急诊
创伤
失血性休克
Fluid resuscitation protocol
Emergency medicine
Trauma
Hemorrhagic shock
作者简介
莫映(1986-),男,本科,主治医师,研究方向为急诊外科医疗诊治工作。
