摘要
目的探讨骨盆骨折合并失血性休克早期液体复苏的方法,以提高存活率,降低死亡率和后期并发症。方法收集本院急诊科2001年2月～2009年12月救治的85例骨盆骨折合并失血性休克临床资料,分为常规液体复苏组A组(42例)和限制性液体复苏组B组(43例),比较复苏4小时后其血清乳酸含量、凝血酶原时间(PT)、血小板计数(PLT)及血细胞比容(HCT)等指标,对比两组患者后期存活率、多器官功能障碍综合征(MODS)、急性呼吸窘迫综合征(ARDS)的发生率及死亡率。结果 A组的死亡率、MODS、ARDS发生率均高于B组(P<0.05),B组血小板数量及红细胞压积明显高于A组,B组血清乳酸水平明显低于A组,B组凝血酶原时间较A组无明显延长,P<0.05。结论限制性输液[收缩压(SBP)维持在70～90mmHg,平均动脉压(MAP)维持在50～60mmHg]在严重骨盆骨折合并失血性休克的早期救治中取得良好的疗效,并明显降低其后期死亡率及并发症的发生率。
Objective To discuss the method of early limited fluid resuscitation in treating pelvic fracture with hemorrhagic shock so as to improve the survival rate,reduce mortality and post-syndrome.Methods Totally 85 patients from Feb.2001 to Dec.2009 were randomly divided into two groups in our emergency department,which included the general fluid resuscitation group（group A,42 cases） and the limited fluid resuscitation group（group B,43 cases）.Indexes associated with the serum lactic acid content,prothrombin time（PT）,blood platelet（PLT） and haematocrit were compared between the two groups within 4 hours following resuscitation.Patients＇ survival rate,incidence and mortality rate of multiple organs dysfunction syndrome（MODS） and acute respiratory distress syndrome（ARDS） were compared.Results The death rate,incidence rate of MODS,ARDS in group A were higher than those in group B（P0.05）.Index of PLT and HCT in group A were higher than those in group B,the serum lactic acid level in group B was significantly lower than that in group A.Meanwhile,there was no significant delay of PT in group B compared with group A（P0.05）.Conclusion The limited transfusion（SBP maintained with 70-90mmHg,MAP maintained with 50-60mmHg） has a good curative effect in the early treatment on pelvic fracture with hemorrhagic shock,and significantly decreases the death rate and complication rate.
出处
《创伤外科杂志》
2011年第5期419-421,共3页
Journal of Traumatic Surgery
关键词
骨盆骨折
失血性休克
液体复苏
pelvic fracture
hemorrhagic shock
fluid resuscitation
