Objective To evaluate the effects of limited fluid resuscitation on septic shock caused by myocardial injury . Methods 60 severe traumatic sepsis and septic shock patients were randomly divided into study group and control group ,with 30 cases in each group ,the control group was given active fluid resuscitation ,maintain the mean arterial pressure (MAP) in 70 mm Hg ;the study group were treated with limited fluid resuscitation ,namely when MAP rose to a slow infusion rate 50-60 mm Hg ,we restrict the amount of fluid ,maintain MAP at about 50 mm Hg ,observe and record the two groups of patients hemodynam-ics index ,APACHE Ⅱ score and heart function index ,and compared serum cTnI ,NT proBNP and CRP in the two groups .Results (1)In study group the infusion volume before admission was (258 ± 105)mL ,preoperative was (558 ± 226)mL ;in the control group that of before admission was (816 ± 422)mL ,preoperative was (1 668 ± 780) mL (P<0 .05) .The mortality rate in study group was 13 .3% ,the mortality in control group rate was 26 .7% (P<0 .05) .(2) the HR and blood lactic acid levels in two groups decreased significantly after treatment ,MAP and CVP increased significantly (P<0 .05);there were no significant differences in hemodynamic parameters (P>0 .05) .(3)After the treatment APACHEⅡscore of the two groups was significantly decreased ,car-diac output ,stroke volume and left ventricular ejection fraction significantly increased in control group ,the study group were better than control group (P<0 .05) .(4) The plasma cTnI ,NT proBNP ,CRP levels of the two groups significantly decreased after treat-ment (P<0 .05) ,plasma cTnI ,NT proBNP and CRP levels of research group were significantly lower than that of control group (P<0 .05) .Conclusion Limited fluid resuscitation can maintain hemodynamic ,reduce the interference on the internal environment ,re-duce myocardial injury ,and improve the success rate of treatment .%目的：评价限制性液体复苏对创伤所致脓毒性休克的治疗效果。方法选择该院救治的创伤所致脓毒性休克的患者60例分为研究组和对照组，各30例，对照组给予积极液体复苏，即早期给予快速、足量补液，维持平均动脉压（MAP）在70 mm Hg左右；研究组给予限制性液体复苏，即当MAP上升至50～60 mm Hg时减慢输液速度，限制补液量，维持MAP在50 mm Hg左右，观察并记录两组患者血流动力学指标、APACHEⅡ评分及心功能指标，并比较两组血浆心肌肌钙蛋白（cTnI）、N末端B型脑钠肽前体（NT-proBNP）、C反应蛋白（CRP）。结果（1）研究组院前输液量为（258±105）mL ，术前输液量为（558±226）mL ，对照组院前输液量为（816±422）m L ，术前输液量为（1668±780）m L ，研究组输液量明显低于对照组（ P＜0．05）。经救治，研究组死亡4例，病死率13．3％，对照组死亡8例，病死率26．7％，研究组病死率明显低于对照组（ P＜0．05）。（2）治疗后两组心率和血乳酸水平明显下降，MAP和中心静脉压明显升高（P＜0．05）；动力学指标比较差异无统计学意义（P＞0．05）。（3）治疗后两组A-PACHEⅡ评分明显降低，每分输出量、每搏输出量及左心室射血分数明显升高，研究组上述指标明显优于对照组（P＜0．05）。（4）治疗后两组患者血浆cTnI、NT-proBNP、CRP水平均明显降低（P＜0．05），研究组血浆cTnI、NT-proBNP、CRP水平明显低于对照组（P＜0．05）。结论限制性液体复苏可以在维持患者血流动力的同时减少对机体内环境的干扰，降低心肌损伤，提高救治成功率。
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