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目的探讨创伤性休克早期的液体复苏方法。方法回顾性分析本院救治的298例创伤性休克患者的临床资料。入院后存活时间超过24h者为存活组,24h内死亡者为死亡组,比较两组患者的ISS评分以及24h内输液量和输血量。并比较手术组和非手术组患者入院后24h内的病死率。结果存活230例(77.2%),死亡68例(22.8%)。死亡组的ISS评分以及输液量和输血量显著多于存活组,其差异具有统计学意义(P<0.01,P<0.05)。手术组的死亡率(10.3%)显著低于非手术组(34.9%),其差异具有统计学意义(P<0.01)。结论大量输液输血并不能提高创伤性休克的抢救成功率,合理的液体复苏、尽早手术控制出血才是抢救成功的关键。
Objective To investigate the early liquid resuscitation method for traumatic shock. Methods The clinical data of 298 patients with traumatic shock treated in our hospital were retrospectively analyzed. Survival after admission for more than 24 hours for the survival group, died within 24 hours for the death group, comparing the two groups of patients with ISS score and transfusion volume and blood transfusion within 24 hours. The mortality of patients in operation group and non-operation group within 24h after admission was compared. Results Survival in 230 patients (77.2%), 68 patients died (22.8%). The ISS score, transfusion volume and transfusion volume in the death group were significantly more than those in the survival group (P <0.01, P <0.05). The mortality of the operation group (10.3%) was significantly lower than that of the non-operation group (34.9%), the difference was statistically significant (P <0.01). Conclusion A large number of transfusion blood transfusion does not improve the success rate of salvage in traumatic shock. Reasonable liquid resuscitation and early surgical control of bleeding are the keys to successful salvage.