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目的:评价限制性液体复苏在严重多发失血性休克救治中的作用。方法:对88例多发创伤合并失血性休克的患者随机分为两组,观察组(n=48)在创伤失血性休克出血未控制前行限制性液体复苏,对照组(n=40)则进行常规行充分液体复苏。比较两组的液体摄入量、输血量、收缩压、术前复苏时间;住院期间急性呼吸窘迫综合征(ARDS)、急性肾功能衰竭(ARF)、弥漫性血管内凝血(DIC)、脓毒血症的发生率和总死亡率。结果:观察组的液体输入量和术前复苏时间均低于对照组,差异有显著性(P<0.05);两组输血量和收缩压差异无显著性。观察组ARDS、脓毒血症的发生率和总死亡率均明显低于对照组,差异有显著性(P<0.05)。结论:在创伤性休克术前未控制性出血条件下,限制性液体复苏可缩短术前复苏时间,明显降低并发症的发生率和死亡率。
Objective: To evaluate the role of restrictive fluid resuscitation in the management of severe multiple hemorrhagic shock. Methods: A total of 88 patients with multiple traumatic hemorrhagic shock were randomly divided into two groups. The observation group (n = 48) performed limited fluid resuscitation before uncontrolled traumatic hemorrhagic shock and the control group (n = 40) Routine full liquid resuscitation. Blood intake, blood transfusion volume, systolic blood pressure and time of preoperative resuscitation were compared between two groups; ARDS, ARF, DIC, The incidence of blood disease and total mortality. Results: The volume of liquid and the time of preoperative resuscitation in the observation group were lower than those in the control group (P <0.05). There was no significant difference between the two groups in the amount of transfusion and the systolic pressure. The incidence of ARDS, sepsis and total mortality in the observation group were significantly lower than those in the control group (P <0.05). CONCLUSION: Restrictive fluid resuscitation can shorten the time of preoperative resuscitation under the condition of uncontrolled hemorrhage before traumatic shock, and significantly reduce the incidence of complications and mortality.