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目的探讨限制性补液在肺挫伤伴失血性休克中的应用效果。方法 2009年1月～2011年1月,某院急诊科收治的肺挫伤伴失血性休克患者62例,依据入院顺序随机分为2组,观察组33例,对照组29例。2组患者均予常规基础治疗,对照组采取充分补液方式,观察组采取限制性补液方式,评价2组临床疗效及预后。结果观察组平均输液量、治疗后平均动脉压(MAP)、中心静脉压(CVP)均低于对照组;观察组治疗后凝血功能、动脉血气分析结果改善均优于对照组;观察组脱机时间明显短于对照组,ARDS及MODS发生率、死亡率等低于对照组。结论限制性补液应用于肺挫伤伴失血性休克,可显著改善凝血功能、缓解低氧血症及酸中毒,缩短脱机时间,降低ARDS、MODS发生率及死亡率,值得临床深入研究。
Objective To investigate the effect of limited fluid replacement in pulmonary contusion with hemorrhagic shock. Methods From January 2009 to January 2011, 62 patients with pulmonary contusion and hemorrhagic shock admitted to an emergency department of a hospital were randomly divided into 2 groups according to admission sequence, 33 in observation group and 29 in control group. The patients in both groups were given routine basic treatment. The control group was given full rehydration method. The observation group was treated with limited rehydration method. The clinical efficacy and prognosis of the two groups were evaluated. Results The mean infusion volume, mean arterial pressure (MAP) and central venous pressure (CVP) after treatment in the observation group were all lower than those in the control group. The improvement of coagulation function and arterial blood gas analysis in the observation group was better than that in the control group. Time was significantly shorter than the control group, ARDS and MODS incidence, mortality and other lower than the control group. CONCLUSION: Restrictive fluid replacement is used in pulmonary contusion with hemorrhagic shock. It can significantly improve coagulation function, relieve hypoxemia and acidosis, shorten the offline time, reduce the incidence of ARDS and MODS and mortality, which deserves further study.