限制性液体复苏在上消化道出血所致失血性休克患者中的应用研究

限制性液体复苏在上消化道出血所致失血性休克患者中的应用
研究
罗亚军;刘音;薛晓艳
【期刊名称】《中国急救复苏与灾害医学杂志》
【年(卷),期】2017(012)004
【摘要】Objective To investigate the therapeutic effects of limited fluid resuscitation on hemorrhagic shock causewd by acute upper gastrointestinal bleeding (UGB).Methods 112 UGB patients with the blood pressure ＜90/60 mmHg were randonly divided into 2 groups:limited fluid resuscitation group (Group 1,n=60) in which limited amount of fluid was transfused to maintain the systolic pressure at the level of 80 ～ 90 mmHg and active recovery of blood volume was performed only after the bleeding was stopped completely;and mass fluid resuscitation group (Group 2,n=52) in which acitive supplimentation of blood volume was conducted since beginning no matter if the bleeding is stopped completely..The outcome was compared bwtween theese 2 groups.Results The survival rate of Group 1 was 11.1％,significantly higher than that of Group 2 (30％,P =0.042),the rebleeding rate of Group 1 was
5.6％,significantly lowewr than that of Group 2 (14.1％,P =0.009),the activated partial thromboplastin time (APTT) of Group 1 was 34.3 sec.,significantly shorter than that of Group 2 (48.7 sec.,P =0.033),the prothrombin time (PT) of Group 1 was 10.3 sec.,significantly shorter than
that of Group 2 (16.2 sec.,P =0.030),and the APACHE Ⅱ score of Group 1 was 9.8,significantly lower than that of Group 2 (17.9,P =0.033).Conclusion Limited fluid resuscitation reduces the mortality of severe hemorrhagic shock,improves the survival rate,and reduces the complications.%目的探讨限制性液体复苏对上消化道出血所致失血性休克患者的救治效果.方法回顾性分析2014年1月-2015年12月间航天中心医院收治的急性上消化道出血所致失血性休克患者早期不同的液体复苏方法对救治效果和并发症的影响.结果在112例急性上消化道出血所致休克患者中,限制性液体复苏组患者病死率(11.1％ vs 30％,P＜0.05)、24 h再出血率(5.6％ vs 14.1％,P＜0.05)、凝血异常(APTT 34.3 vs 48.7,P ＜0.05;PT10.3 vs 16.2,P＜0.05)及APACHE Ⅱ评分(9.8 vs 17.9,P＜ 0.05)等均低于积极液体复苏组.结论限制性液体复苏能降低急性失血性休克患者病死率及并发症,改善患者预后.
【总页数】3页(P324-326)
【作者】罗亚军;刘音;薛晓艳
【作者单位】航天中心医院重症医学科,北京100049;航天中心医院重症医学科,北京100049;航天中心医院重症医学科,北京100049
【正文语种】中文
【中图分类】R541.64
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