崔传义 汪琦 袁龙

【摘要】 目的：研究限制性液体复苏救治方法用于多发伤致创伤性失血性休克治疗中的价值。方法：选取2016年10月-2019年10月收治的94例多发伤致创伤性失血性休克患者，按照随机数字表法分为两组，每组各47例。对照组实施积极液体复苏治疗，观察组实施限制性液体复苏治疗，比较两组的治疗效果。结果：两组患者復苏后的K+低于复苏前，Na+、Mg2+均高于复苏前，差异均有统计学意义（P<0.05）;观察组患者复苏后的Hb高于对照组，PT、APTT低于对照组，差异均有统计学意义（P<0.05）;观察组患者的复苏时间短于对照组，复苏输入液体量、复苏1 h后的乳酸水平低于对照组，并发症发生率、死亡率亦低于对照组，差异均有统计学意义（P<0.05）。结论：于多发伤致创伤性失血性休克患者治疗中应用限制性液体复苏救治方法能够改善电解质和凝血指标情况，缩短复苏时间，有助于提升抢救效果。

【关键词】 多发伤 创伤 失血性休克 限制性液体复苏

The Value of Limited Fluid Resuscitation in the Treatment of Traumatic Hemorrhagic Shock Caused by Multiple Injuries/CUI Chuanyi， WANG Qi， YUAN Long. //Medical Innovation of China， 2021， 18（07）： 0-017

[Abstract] Objective： To study the value of limited fluid resuscitation in the treatment of traumatic hemorrhagic shock caused by multiple trauma. Method： This study included 94 patients with traumatic hemorrhagic shock from October 2016 to October 2019. They were divided into two groups according to the random number table， 47 cases in each group. The control group was treated with active fluid resuscitation， the observation group was treated with restrictive fluid resuscitation. The therapeutic effects of the two groups were compared. Result： After resuscitation， the level of K+ was lower than before resuscitation， while the levels of Na+ and Mg2+ were higher than before resuscitation， the differences were statistically significant （P<0.05）. After resuscitation， the level of Hb in observation group was higher than that of control group， the levels of PT and APTT were lower than those of control group， the differences were statistically significant （P<0.05）. The time of resuscitation in the observation group was shorter than that in the control group， the amount of fluid input and lactate level 1 h after resuscitation were lower than those in the control group， and the incidence of complications and mortality were also lower than those in the control group，the differences were statistically significant （P<0.05）. Conclusion： The application of limited fluid resuscitation in the treatment of multiple trauma patients with traumatic hemorrhagic shock can improve the electrolyte and coagulation index， shorten the resuscitation time， and improve the rescue effect.

[Key words] Multiple injuries Trauma Hemorrhagic shock Limited fluid resuscitation

First-authors address： Xiaogan Central Hospital， Xiaogan 432000， China

doi：10.3969/j.issn.1674-4985.2021.07.004

多发伤引起的创伤性失血性休克会促使患者迅速失血且失血量超过全身血量的15%～20%，导致因微循环障碍而出现组织器官功能不全或衰竭等情况发生[1]，会严重威胁到患者的生命安全。失血速度和失血量是影响该病严重程度的重要因素[2-3]，因此在对多发伤致创伤性失血性休克患者进行治疗期间，应快速补充血容量、补液、改善组织灌注[4]。液体复苏救治是挽救此类患者生命的重要手段，而充分的液体复苏所取得的效果已被临床肯定。本文就限制性液体复苏于多发伤致创伤性失血性休克患者治疗中的效果进行分析，旨在提升抢救效果和改善预后，现报道如下。

1 资料与方法

1.1 一般资料 选取2016年10月-2019年10月本院接收的94例多发伤致创伤性失血性休克患者，根据随机数字表法分为对照组、观察组，每组各47例。纳入标准：（1）所有患者均符合《创伤失血性休克复苏新理念及2007欧洲治疗指南》中关于创伤性失血性休克的診断标准，并结合临床检查结果确诊;（2）受伤至抢救时间在24 h内的患者;（3）简明损伤评分（AIS）≥16分。……