Clinical study on restrictive fluid resuscitation combined with damage control resuscitation in severe traumatic spleen rupture
限制性液体复苏联合损伤控制性复苏在严重创伤性脾破裂中的临床应用研究

摘要

目的 探究在严重创伤性脾破裂治疗中限制性液体复苏与损伤控制性复苏联合运用的临床实践效果。方法 本研究选择纳入我院的70例严重创伤性脾破裂患者作为研究对象。采用随机数字表法分配至对照组（35例，采用积极液体复苏）与研究组（35例，采用限制性液体复苏与损伤控制性复苏联合干预）。对比两组的干预效果。结果 相较于对照组，研究组患者的凝血酶原时间、活化部分凝血活酶时间及乳酸水平均显著降低，剩余碱含量则明显升高；同时研究组患者的胶体溶液与晶体溶液输注量显著减少，而血浆及浓缩红细胞的输注量明显增加，差异有统计学意义（P＜0.05）。结论 将限制性液体复苏与损伤控制性复苏联合应用于严重创伤性脾破裂患者，能够显著优化其凝血机能，进而对患者的整体预后状况产生积极改善作用。

Abstract

Objective Investigate the clinical practice effects of combined use of restrictive fluid resuscitation and damage control resuscitation in the treatment of severe traumatic splenic rupture.
Methods This study selected 70 patients with severe traumatic splenic rupture from our hospital as research subjects. They were randomly assigned using a random number table to the control group (35 cases, receiving aggressive fluid resuscitation) and the study group (35 cases, receiving a combined intervention of restrictive fluid resuscitation and damage control resuscitation). The intervention effects of the two groups were compared.
Results Compared to the control group, the patients in the study group had significantly reduced prothrombin time, activated partial thromboplastin time, and lactate levels, while their base excess levels were significantly increased; at the same time, the infusion volumes of colloid and crystalloid solutions in the study group were significantly reduced, whereas the infusion volumes of plasma and concentrated red blood cells were significantly increased, with the differences being statistically significant (P<0.05).
Conclusion   Combining restrictive fluid resuscitation with damage control resuscitation in patients with severe traumatic splenic rupture can significantly optimize their coagulation function, thereby positively improving their overall prognosis.