限制性液体复苏治疗失血性休克的45例临床疗效

摘要

目的：探讨限制性液体复苏治疗失血性休克的临床疗效，以期为失血性休克的临床治疗提供经验。方法：回顾性分析本院急诊科收治的77例失血性休克患者临床资料，根据液体复苏方法的不同分为观察组和对照组，观察组45例用限制性液体复苏治疗，对照组32例采用充分液体复苏治疗，对比观察两组术前输液量、凝血酶原时间、红细胞积压、死亡率以及存活患者急性肾功能衰竭（ARF）、多器官功能障碍综合征（MODS）、急性呼吸窘迫综合征（ARDS）、弥漫性血管内凝血（DIC）等并发症发生率。结果：观察组输液量、凝血酶原时间显著低于对照组，红细胞积压显著高于对照组；观察组病死率为8.89%，显著低于对照组的18.75%；存活患者中，观察组并发症发生率为17.07%，显著低于对照组的34.62%，比较差异均有统计学意义（P<0.05）。结论：限制性液体复苏治疗失血性休克疗效显著，可以显著降低病死率和并发症发生率，值得进一步深入研究。%Objective: To explore the curative effect of 45 Uncontrolled hemorrhagic shock patients treated with Restrictive liquid recovery, in order to provide experience for the clinical treatment of uncontrolled hemorrhagic shock. Method: To retrospectively analyze the clinical data of 77 uncontrolled hemorrhagic shock patients admitted in our hospital emergency clinic, they were divided into observation group and control group depending on the liquid recovery methods. 45 patients in the observation group were treated with restrictive liquid recovery treatment, 32 patients in the control group were treated with sufficient liquid recovery treatment. To compare the preoperative transfusion amount, prothrombin time, backlog of red blood cells, mortality, and survival in patients with acute renal failure (ARF) and multiple organ dysfunction syndrome (MODS) and acute respiratory distress syndrome (ARDS), diffuse intravascular coagulation (DIC), and other complications between the two groups.Result: The preoperative transfusion amount, prothrombin time in the observation group was significantly lower than that of the control group,while the backlog of red blood cells was significantly higher than that of the control group, the difference was statistical significance (P<0.05). The fatality rate of the observation group was 8.89%, it’s significantly less than 18.75% of the control group, the difference was statistically significant (P<0.05). Among survival patients, the complication rate of the observation group was 17.07%, it’s significantly less than 34.62% of the control group, the difference was statistically significant (P<0.05). Conclusion: Restrictive liquid recovery uncontrolled hemorrhagic shock with obvious therapeutic effect, can significantly reduce the mortality and complication rates, deserves further research.