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    度学文, 吴卫华, 顾颖. 限制性体液复苏对失血性休克院前急救患者血气指标与凝血功能的影响[J]. 徐州医科大学学报, 2021, 41(9): 681-684. DOI: 10.3969/j.issn.2096-3882.2021.09.012
    引用本文: 度学文, 吴卫华, 顾颖. 限制性体液复苏对失血性休克院前急救患者血气指标与凝血功能的影响[J]. 徐州医科大学学报, 2021, 41(9): 681-684. DOI: 10.3969/j.issn.2096-3882.2021.09.012

    限制性体液复苏对失血性休克院前急救患者血气指标与凝血功能的影响

    • 摘要: 目的探讨限制性液体复苏对失血性休克院前急救患者血气指标与凝血功能的影响。方法选取2015年8月—2017年8月上海市松江区医疗急救中心送往急诊科进行院前急救的112例失血性休克患者,分为研究组和对照组(n=56),对照组采用常规液体复苏,研究组采用限制性液体复苏。对比2组患者进入急诊时及进入急诊后60、120、180 min的血气指标与凝血功能的差异。结果研究组实施院前急救限制性液体复苏后各时间点动脉血氧分压(PaO2)、剩余碱(BE)测量值显著高于对照组(P<0.05),血清乳酸(BL)测量值显著低于对照组(P<0.05);研究组实施院前急救限制性液体复苏后60、120、180 min测定的凝血酶原时间(PT)、部分凝血活酶时间(APTT)显著低于对照组(P<0.05), 血小板(PLT)计数显著高于对照组(P<0.05);研究组实施院前急救后弥散性血管内凝血(DIC)发生率、病死率显著低于对照组(P<0.05)。结论采用限制性体液复苏对失血性休克患者进行院前急救,能更好地改善患者血气指标、凝血功能,降低DIC的发生率和病死率。

       

      Abstract: Objective To investigate the effect of slow and limited-volume fluid resuscitation on blood gas index and coagulation function in pre-hospital emergency patients with hemorrhagic shock. Methods 112 patients with hemorrhagic shock who received pre-hospital emergency treatment in our hospital from August 2015 to August 2017 were selected. 56 patients in the study group were treated with slow and limited-volume fluid resuscitation and 56 patients in the control group were treated with routine fluid resuscitation. We compared the difference the two groups’ blood gas index and coagulation function when they came into emergency department and 60min, 120min and 180min after treatment. Results The arterial partial pressure of oxygen (PaO2) and base access (BE) in the study group were significantly higher than those in the control group (P < 0.05), the BL in the study group were significantly lower than those in the control group (P < 0.05), the prothrombin time (PT) and activated partial thromboplastin time (APTT) in 60 minutes, 120 minutes and 180 minutes after fluid slow and limited-volume fluid resuscitation in the study group were significantly lower than those in the control group (P < 0.05) ,the PLT in 60, 120 and 180 minutes after slow and limited-volume treatment in the study group was significantly higher than that of the control group (P < 0.05), and the DIC incidence and mortality of the study group were significantly lower than that of the control group after slow and limited-volume treatment (P < 0.05).Conclusion Slow and limited-volume fluid resuscitation can improve blood gas index, coagulation function, and reduce the incidence of Disseminated intravascular coagulation(DIC) and the mortality in patients with hemorrhagic shock

       

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