摘要
目的比较不同液体复苏方案对急诊创伤失血性休克患者的抢救结局及其对患者电解质水平、应激反应指标的影响。方法采用随机数字表法将105例急诊创伤失血性休克患者分为对照组52例与观察组53例,对照组给予积极液体复苏方案,观察组给予限制液体复苏方案。比较2组的抢救成功率及治疗前后电解质水平(包括K+、Na+、Cl-和Mg2+)、应激反应指标[包括去甲肾上腺素(NE)、皮质醇(COR)、空腹血糖(GLU)]变化情况。结果观察组抢救成功率显著高于对照组(94.33%比80.76%,χ^(2)=4.4558,P=0.0348);2组治疗后电解质水平、应激反应指标水平均较治疗前显著降低,且观察组降低幅度明显高于对照组,差异均有统计学意义(均P<0.05)。结论限制性液体复苏能够提高创伤性失血性休克患者抢救成功率,维持患者血流灌注,降低酸中毒,改善应激反应。
Objective To study the effects of different fluid resuscitation schemes on rescue outcomes,electrolyte levels and stress reactions in emergency patients with traumatic hemorrhagic shock.Methods A total of 105 patients with traumatic hemorrhagic shock were randomly treated with either active fluid resuscitation program(control group,52 patients)or restricted fluid resuscitation program(observation group,53 patients).Rescue success rate,electrolyte levels(K+,Na+,Cl-and Mg2+)and stress response indexes(noradrenaline,cortisol and fasting blood glucose)were compared between the two groups.Results The rescue success rate in the observation group was higher than that in the control group(94.33%vs 80.76%,χ^(2)=4.4558,P=0.0348).After treatment,the levels of electrolyte and stress response indexes decreased in both groups,and the decrease in the observation group was more obvious than that in the control group(P<0.05).Conclusion Restricted fluid resuscitation can increase rescue success rate,maintain blood perfusion,reduce acidosis and improve stress response in patients with traumatic hemorrhagic shock.
作者
张琳
张盼盼
ZHANG Lin;ZHANG Pan-pan(Emergency Department,Hebi People’s Hospital,Hebi 458030,China)
出处
《实用临床医学（江西）》
CAS
2021年第3期23-25,43,共4页
Practical Clinical Medicine
关键词
液体复苏
失血性休克
创伤
急诊
电解质水平
应激反应
liquid resuscitation
hemorrhagic shock
trauma
emergency
electrolyte levels
stress response
